Remote Pharmacy Technician: Prior Authorization

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

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

PTO / Time Off

Employee Assistance Program

Health Spending Account (HSA)

Job summary

Actalent is recruiting for a Remote Pharmacy Technician Prior Authorization to process and review Medicare/Medicaid prior authorization requests in a fully remote setting. You will handle intake, perform technical reviews, and determine coverage decisions while maintaining HIPAA compliance.

Training will cover SOPs and insurance documentation, followed by independent work in a structured, distraction-limited home office.

Qualifications

• Active pharmacy technician certification (e.g., CPhT).
• Experience as a pharmacy technician in managed care or prior authorization.
• Experience with Medicare/Medicaid populations and claims processing.
• Strong data entry with high accuracy and attention to detail.
• Phone-based customer service experience and ability to handle calls professionally.

Responsibilities

• Process intake of prior authorization requests in internal systems.
• Route and perform technical review of prior authorization cases.
• Determine medication coverage decisions (approve/deny/partial).
• Interpret coverage criteria, SOPs, and insurance documents to assess eligibility.
• Make clinical determinations per guidelines and policies.
• Enter data accurately for claims and prior authorizations.
• Provide professional phone-based customer service to patients and providers.
• Work independently in a remote setting with high productivity.
• Ensure HIPAA compliance and privacy in a distraction-limited environment.
• Support rotating holiday coverage and training updates.

Skills

Pharmacy technician certification (CPh

Prior authorization experience

Medicare/Medicaid experience

Data entry accuracy

Phone-based customer service

Remote work capability

Job description

Actalent is recruiting for a Remote Pharmacy Technician Prior Authorization to process and review Medicare/Medicaid prior authorization requests in a fully remote setting. You will handle intake, perform technical reviews, and determine coverage decisions while maintaining HIPAA compliance.

Training will cover SOPs and insurance documentation, followed by independent work in a structured, distraction-limited home office.