Remote Pharmacy Technician - Prior Authorization Expert

SmithRx; Phoenix (AZ); Remote; USD 26,000 - 34,000; Full time

Benefits offered by this job

Bonuses, commissions or equity

Medical, dental, vision benefits

Mental health support

Paid parental leave

Life and disability insurance

401(k)

Job summary

SmithRx, a dynamic Health-Tech company, is seeking a Pharmacy Technician for a 6‑month contract. You will assist members, providers, pharmacies, and internal teams to navigate prescriptions and ensure timely coverage of clinically appropriate medications.

Role involves coordinating clinical reviews, validating plan rules, and triaging inquiries. Remote work eligible for select states; strong attention to detail and empathy are essential.

Qualifications

• High School diploma or GED or equivalent work experience.
• Active Pharmacy Technician license required.
• 2-4 years of experience as a Pharmacy Technician.
• Experience in prior authorization review (PBM/health plan) preferred.
• Proficiency in Mac, MS Office, G-Suite.

Responsibilities

• Verify eligibility and drug coverage under the plan benefit design to determine appropriate claims processing.
• Triaging the process of clinical review for prior authorization requests at different levels.
• Review prior authorization and similar requests under protocol using criteria, history and rules; outreach to verify information.
• Organize and prioritize multiple requests to ensure timely prior authorization case management.
• Build and adjust authorizations under protocol within the claim adjudication system.
• Navigate drug products, formulations, and perform basic calculations for accurate adjudication.
• Critically assess multiple workflows to make sound clinical decisions.
• Coordinate outreach and address questions with internal and external teams.
• Evaluate member situations against medication policies and approve or triage to Pharmacist for denial.
• Know when to trigger internal/external reviews based on protocols.
• Reach out to external stakeholders for drug approvals with dollar limits.

Skills

Pharmacy technician

Prior authorization

Empathy

Multitasking

Effective communication

MS Office

G-Suite

Mac proficiency

Education

High School diploma or GED

Active Pharmacy Technician license

Tools

Mac

MS Office

G-Suite

Job description

SmithRx, a dynamic Health-Tech company, is seeking a Pharmacy Technician for a 6‑month contract. You will assist members, providers, pharmacies, and internal teams to navigate prescriptions and ensure timely coverage of clinically appropriate medications.

Role involves coordinating clinical reviews, validating plan rules, and triaging inquiries. Remote work eligible for select states; strong attention to detail and empathy are essential.