Remote Pharmacy Technician: Prior Authorization Specialist

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

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