Remote Pharmacy Tech: Prior Auth & PBM Coverage

Actalent; Fort Worth (TX); Remote; USD 28,000 - 32,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) plan

Remote work options

Contract role

Job summary

Actalent is seeking a Pharmacy Technician for a contract role based out of Fort Worth, TX. The technician will track and triage coverage determination requests for prior authorizations and Medicare Part D recipients, supporting clinical review by gathering information and applying criteria to approve requests where appropriate.

The role requires a state license, 1 year of pharmacy experience, and strong documentation and communication skills to ensure timely, accurate coverage decisions for

Qualifications

• High school diploma or equivalent required.
• At least 1 year of experience in a retail, hospital, or mail order pharmacy setting.
• Current state Pharmacy Technician license.
• Experience handling prior authorization or coverage determination processes.

Responsibilities

• Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients.
• Review incoming requests and determine when pharmacist review is required.
• Obtain verbal authorizations from prescribers and request detailed clinical information.
• Apply criteria to approve coverage determinations within scope of role.
• Enter and document decisions accurately in the PBM system.
• Notify providers and members of coverage decisions clearly and timely.
• Respond to client inquiries regarding approvals and processes.
• Refer complex determinations to delegated vendors as needed.
• Communicate decisions to physicians, providers, and members professionally.

Skills

Retail Pharmacy

PBM knowledge

Prior Authorization

Documentation

Verbal Communication

Attention to Detail

Education

High school diploma or equivalent

State Pharmacy Technician license

CPhT preferred

Job description

Actalent is seeking a Pharmacy Technician for a contract role based out of Fort Worth, TX. The technician will track and triage coverage determination requests for prior authorizations and Medicare Part D recipients, supporting clinical review by gathering information and applying criteria to approve requests where appropriate.

The role requires a state license, 1 year of pharmacy experience, and strong documentation and communication skills to ensure timely, accurate coverage decisions for