Remote Prior Authorization Pharmacy Tech – Medicare/Medicaid

Actalent; Chicago (IL); Teletrabalho; USD 28 000 - 32 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical, dental & vision

401(k) retirement plan

Paid time off

Disability coverage

Life Insurance

Resumo da oferta

Actalent is hiring a Remote Pharmacy Technician Prior Authorization to support Medicare and Medicaid patients in a fully remote role. You will handle intake, perform technical reviews, and make coverage determinations according to established criteria and SOPs while maintaining HIPAA compliance.

The role emphasizes accurate data entry, strong communication with patients and providers, and independent work in a remote setting with flexible scheduling.

Qualificações

• Active pharmacy technician certification (CPhT) required.
• Hands-on pharmacy technician experience, preferably in managed care.
• Experience with Medicare/Medicaid populations and prior authorization processes.
• Prior authorization intake, review, or claims-related activities.
• Strong data entry with high accuracy.

Responsabilidades

• Process intake and setup of prior authorization requests in internal systems.
• Route cases to review team and perform technical QA on PA cases.
• Determine coverage decisions (approve/deny/partial) based on criteria and SOPs.
• Read and interpret coverage criteria, insurance documents, and medical records.
• Provide professional, phone-based customer service to patients and providers.

Conhecimentos

CPhT certification

Remote work experience

Phone-based customer service

Data entry accuracy

HIPAA compliance

Pharmacy terminology

Independent work

Ferramentas

MedPharm/claims processing systems

EHR systems

Remote work software

Descrição da oferta de emprego

Actalent is hiring a Remote Pharmacy Technician Prior Authorization to support Medicare and Medicaid patients in a fully remote role. You will handle intake, perform technical reviews, and make coverage determinations according to established criteria and SOPs while maintaining HIPAA compliance.

The role emphasizes accurate data entry, strong communication with patients and providers, and independent work in a remote setting with flexible scheduling.