Remote Pharmacy Technician

Actalent; San Antonio (TX); Remote; USD 28,000 - 32,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) retirement plan

Paid time off

Remote work

Job summary

Actalent in the United States is seeking a certified Pharmacy Technician to manage prior authorizations for Medicare and Medicaid in a fully remote role, handling intake and technical review and ensuring timely access to medications. This position blends data entry, clinical review, and phone-based support while working independently in a structured, supportive team setting.

The role offers training and growth into full technical review capabilities, with schedules that may include evenings and

Qualifications

• Active Pharmacy Technician certification (CPhT) with eligibility to perform duties.
• Pharmacy technician experience, preferably in managed care.
• Hands-on experience with PBM or prior authorization workflows.
• Strong data entry accuracy and attention to detail.
• Phone-based customer service in healthcare/pharmacy.
• Ability to guide conversations and stay professional.
• Proficient with computers and multiple systems.
• Ability to work independently in a remote environment.
• Good reading comprehension to interpret criteria and SOPs.
• Capability to make clinical determinations within scope.
• Reliable high-speed internet for remote work.

Responsibilities

• Process PA requests for Medicare/Medicaid patients with focus on Medicare.
• Intake MedPharm PA requests and set up cases in internal systems.
• Route intake to review team and perform intake/technical review as needed.
• Conduct technical review by reading criteria, SOPs, insurance docs, medical records.
• Make coverage determinations and document decisions in systems.
• Maintain accurate case records with data-entry best practices.
• Provide phone-based customer service for inquiries and coverage topics.
• Steer conversations to obtain required information while remaining professional.
• Collaborate remotely to ensure timely case processing and holiday coverage.
• Follow HIPAA and confidentiality requirements in a remote setting.
• Participate in training to expand from intake to full technical review.
• Adhere to schedules including evenings, weekends, and training periods.
• Utilize multiple computer systems to manage workflow and documentation.

Skills

Pharmacy technician certification (CPh

Managed care experience

Pharmacy benefit processes

Data entry accuracy

Phone-based customer service

Phone conversation control

Computer proficiency

Remote work capability

Reading comprehension

Clinical coverage determinations

Stable internet connectivity

Tools

MedPharm

Job description

Job Description

This role offers an opportunity for a certified Pharmacy Technician to support patients by managing prior authorizations for Medicare and Medicaid prescriptions in a fully remote environment. You will handle both intake and technical review functions, using your pharmacy and managed care experience to determine coverage and ensure patients receive timely access to their medications. This position combines detailed data entry, clinical review, and phone-based customer service while working independently in a structured, supportive team setting.

Job Title: Remote Pharmacy Technician Prior Authorization Specialist

This role offers an opportunity for a certified Pharmacy Technician to support patients by managing prior authorizations for Medicare and Medicaid prescriptions in a fully remote environment. You will handle both intake and technical review functions, using your pharmacy and managed care experience to determine coverage and ensure patients receive timely access to their medications. This position combines detailed data entry, clinical review, and phone-based customer service while working independently in a structured, supportive team setting.

Responsibilities

• Process prior authorization (PA) requests for Medicare and Medicaid patients, with a primary focus on Medicare cases.
• Perform intake of MedPharm prior authorization requests by gathering required information and accurately setting up PA cases in internal systems.
• Route completed intake cases to the review team and, once trained, perform both intake and technical review functions as needed.
• Conduct technical review of PA cases by carefully reading and interpreting criteria, standard operating procedures (SOPs), insurance documents, and medical records.
• Make clinical determinations on medication coverage, including whether a prescription should be approved, denied, or covered under specific conditions.
• Document all decisions clearly and accurately in the appropriate systems, ensuring compliance with internal policies and regulatory requirements.
• Use strong data entry skills to maintain accurate, up-to-date records for each prior authorization case.
• Provide customer service over the phone, handling inbound and outbound calls related to prior authorizations and coverage determinations.
• Control and guide conversations with callers, redirecting as needed to obtain required information and maintain a professional, efficient interaction.
• Collaborate with team members in a remote environment to ensure timely processing of cases and equitable distribution of rotating holiday coverage.
• Follow all HIPAA and confidentiality requirements when handling patient information and working in a remote setting.
• Participate in training and ongoing development to expand from intake responsibilities into full technical review capabilities.
• Adhere to established schedules, including evening and weekend shifts, and manage time effectively during training and regular operations.
• Utilize computer systems and software tools efficiently to manage workflow, review documentation, and communicate with colleagues.

Essential Skills

• Active Pharmacy Technician certification (such as CPhT) with eligibility to perform pharmacy technician duties.
• Pharmacy technician experience, preferably in a managed care or similar environment.
• Hands‑on experience with managed care or pharmacy benefit processes, including prior authorization workflows.
• Strong data entry skills with a high level of accuracy and attention to detail.
• Demonstrated experience providing customer service over the phone, including handling calls related to healthcare or pharmacy services.
• Ability to control and guide phone conversations, redirect discussions when necessary, and maintain a calm, professional demeanor.
• Proficiency with computers and common software tools, including the ability to learn and navigate multiple systems simultaneously.
• Ability to work independently and effectively in a fully remote environment with minimal direct supervision.
• Strong reading comprehension skills to interpret criteria, SOPs, insurance policies, and medical documentation.
• Capability to make sound clinical coverage determinations within the scope of a pharmacy technician role.
• Reliable high‑speed internet connection and the technical ability to support remote work requirements.

Additional Skills & Qualifications

• Previous experience working with Medicare and Medicaid patient populations.
• Background in a pharmacy setting that involved claims processing, insurance coordination, or prior authorizations.
• Familiarity with MedPharm or similar prior authorization platforms and workflows.
• Experience in managed care pharmacy, including understanding of coverage criteria and benefit structures.
• Strong organizational skills and the ability to manage multiple cases and priorities in a fast‑paced environment.
• Effective written and verbal communication skills for documenting decisions and interacting with patients, providers, and team members.
• Comfort working flexible schedules, including evenings, weekends, and rotating holiday coverage.
• Interest in long‑term opportunities that may include conversion to a permanent role with access to holiday benefits, paid time off, flexibility, and other benefits, subject to employer policies.

Work Environment

This is a 100% remote position that requires working from a closed‑door setting with limited distractions to maintain confidentiality and productivity. The work environment must be fully HIPAA compliant, and you must have strong, reliable Wi‑Fi to support continuous system access, calls, and documentation. Training is conducted Monday through Friday from 10:00 a.m. to 6:30 p.m. Eastern Time. After training, schedules follow either a Sunday‑Thursday or Tuesday‑Saturday pattern. For a Sunday‑Thursday schedule, preferred hours are 12:00-8:30 p.m. or 12:30-9:00 p.m. Eastern Time, with Sunday shifts typically 8:00 a.m. to 4:30 p.m. Eastern Time. For a Tuesday‑Saturday schedule, preferred hours are 12:30-9:00 p.m. Eastern Time on Tuesday through Friday, with Saturday shifts typically 8:00 a.m. to 4:30 p.m. Eastern Time. Holiday coverage rotates among team members. Lunch breaks range from 30 minutes to approximately one hour, coordinated with operational needs. The role relies heavily on computer‑based systems, electronic documentation, and phone communication, and you will work as part of a culturally strong, supportive team that values flexibility, benefits, and a positive internal environment.

Job Type & Location

This is a Contract to Hire position based out of San Antonio, TX.

Pay And Benefits

The pay range for this position is $20.00 - $23.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job‑related factors.

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)

Application Deadline

This position is anticipated to close on Nov 17, 2026.

Workplace Type

This is a fully remote position.

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 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News‑Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

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 process due to a disability, please email [e-mail] for other accommodation options.

San Francisco Fair Chance Ordinance

Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI)

We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.