Remote Pharmacy Prior Authorization Specialist

Actalent; Colorado Springs (CO); Remote; USD 28,000 - 32,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Paid Time Off

Job summary

Actalent is hiring a Remote Pharmacy Technician Prior Authorization to process Medicare/Medicaid PA requests from a home office. You will intake requests, perform technical reviews, and make coverage determinations aligned with SOPs and documented criteria.

Requires active CPhT and prior authorization experience in managed care, with strong data entry and customer service skills. Remote, contract-to-hire, with competitive pay and benefits.

Qualifications

• Active pharmacy technician certification (CPhT)
• Hands-on experience as a pharmacy technician, preferably in managed care or prior authorization
• Experience with Medicare/Medicaid populations and prior authorization
• Prior authorization intake/review/claims-related activities
• Strong data entry accuracy and attention to detail
• Proficiency with remote-work systems and HIPAA compliance

Responsibilities

• Process intake of prior authorization requests in internal systems.
• Route cases to the review team and perform technical reviews.
• Determine medication coverage decisions (approve/deny/partial).
• Interpret coverage criteria and SOPs for eligibility.
• Enter data accurately for claims and patient information.
• Provide professional phone-based customer service to patients and providers.
• Work independently in a remote setting and meet performance standards.

Skills

CPhT Certification

Pharmacy Tech

Prior Authorization

Managed Care

Data Entry

Remote Communication

HIPAA

Independent Work

Tools

Internal Systems

Claims Processing

Job description

Actalent is hiring a Remote Pharmacy Technician Prior Authorization to process Medicare/Medicaid PA requests from a home office. You will intake requests, perform technical reviews, and make coverage determinations aligned with SOPs and documented criteria.

Requires active CPhT and prior authorization experience in managed care, with strong data entry and customer service skills. Remote, contract-to-hire, with competitive pay and benefits.