Remote Pharmacy Technician

Lensa; Chicago (IL); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare insurance company is seeking a dedicated Remote Certified Pharmacy Technician to manage review processes for Prior Authorizations. In this role, you will make crucial approval or denial decisions before final review by Pharmacists, ensuring effective communication with all stakeholders while working from a professional remote environment.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Short and long-term disability

Health Spending Account (HSA)

Qualifications

• High School diploma or GED required.
• State Registration and National Certification necessary.
• Experience with Prior Authorization processes essential.

Responsibilities

• Review Prior Authorizations for coverage determination.
• Approve or deny requests based on established criteria.
• Notify providers and members regarding decisions made.

Skills

Basic computer skills

Data entry skills

Proficiency in Microsoft Office and Outlook

Education

High School diploma or GED

State Registration AND National Certification

Experience with Prior Authorization processes

Job description

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Job Title: Remote Certified Pharmacy Technician

Job Description

We are seeking a dedicated Remote Pharmacy Technician to join our team working in the EST time zone. As a Pharmacy Technician, you will be responsible for reviewing Prior Authorizations for coverage determination for a Pharmacy Services department within a large healthcare insurance company. You will make initial approval or denial decisions before passing them to Pharmacists for final review.

Responsibilities

• Track coverage determination requests
• Obtain verbal authorizations
• Approve requests based on criteria
• Enter decisions into the PBM system
• Notify providers and members of decisions
• Respond to client inquiries
• Refer requests for specialty drugs
• Contact providers for additional information
• Notify stakeholders of decision outcomes
• Obtain detailed clinical information from prescribers
• Assist with inbound and/or outbound patient or physician calls if needed
  
  

Requirements

• High School diploma or GED
• State Registration AND National Certification
• Basic computer skills
• Experience with Prior Authorization processes
• Proficiency in Microsoft Office and Outlook
• Data entry skills
  
  

Work Environment

• This is a professional remote environment where you will work with multiple screens and systems.
• You must have a strong WiFi connection and a dedicated office space with a closed door.
• The shift is Monday to Friday, from 8 am to 8 pm (Open for 8-Hour Shifts) in your local time zone, with rotating weekends every 4-6 weeks and some holidays. Training is conducted from 10 am to 6:30 pm EST.
• The company provides equipment, including a computer, monitor, and headset.
  
  

Pay and Benefits

The pay range for this position is $18.00 - $19.00/hr.

Eligibility Requirements Apply To Some Benefits And May Depend On Your Job Classification And Length Of Employment. Benefits Are Subject To Change And May Be Subject To Specific Elections, Plan, Or Program Terms. If Eligible, The Benefits Available For This Temporary Role May Include The Following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
  
  

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Jun 10, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email [e-mail] ([e-mail]) for other accommodation options.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  IT Services and IT Consulting

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