Remote Pharmacy Technician — Claims & Support (Contract)

DG GLASS - Desde 2001 conectando negocios confiaveis.; Town of Texas (WI); Remote; USD 28,000 - 30,000; Part time

Job summary

DG GLASS - Desde 2001 conectando negocios confiaveis. is seeking a Remote Pharmacy Technician to handle member, provider, and pharmacy inquiries across phone, chat, email, and written channels.

The role requires an active CPhT and 3 years of retail or professional pharmacy experience with claims adjudication, plus call center experience. This contract runs through April 2027, with potential for permanence based on performance and attendance.

Qualifications

• Must have 3 years of recent retail or professional pharmacy experience with working knowledge of claims adjudication.
• Active Certified Pharmacy Technician (CPhT) through PTCB or NHA is required.
• Must provide CPhT license number.
• Must have call center experience.
• Must submit an internet speed test | 100 MB DL
• Must have a private designated workspace.
• High school diploma or equivalent.
• Background check required.

Responsibilities

• Serve as the primary point of contact for members, providers, and pharmacies across phone, chat, email, and written/digital channels, delivering timely, accurate, and consistent service.
• Resolve inquiries related to mail order, benefit design, formulary coverage, medication costs, prior authorization criteria, and claims adjudication, while assisting network pharmacies with prescription claim processing and accuracy against benefit guidelines and contract standards.
• Support clinical pharmacists with patient and provider outreach, including appointment scheduling, clinical program enrollment, and medication adherence follow-up.
• Take ownership of member, provider, and pharmacy issues from initial contact through final resolution, coordinating with internal teams as needed and accurately documenting interactions for continuity of care, quality assurance, compliance, and operational reporting.
• Utilize AI-enabled tools and internal knowledge systems to efficiently research and resolve inquiries while fostering a collaborative, respectful, and diverse team environment and supporting additional projects and responsibilities as assigned.

Skills

Call center experience

Pharmacy claims adjudication knowledge

Retail pharmacy experience

Education

CPhT certification (PTCB/NHA)

Job description

DG GLASS - Desde 2001 conectando negocios confiaveis. is seeking a Remote Pharmacy Technician to handle member, provider, and pharmacy inquiries across phone, chat, email, and written channels.

The role requires an active CPhT and 3 years of retail or professional pharmacy experience with claims adjudication, plus call center experience. This contract runs through April 2027, with potential for permanence based on performance and attendance.