Remote Prior Authorization Pharmacy Tech (Medicare/Medicaid)

Actalent; St. Louis (MO); Remote; USD 28,000 - 30,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Paid time off

Job summary

Actalent is seeking a dedicated Pharmacy Technician to support Medicare/Medicaid patients, focusing on prior authorizations within a MedPharm environment. This remote role requires strong data-entry skills and HIPAA compliance.

Training and schedule details are provided once onboarded. The position emphasizes intake and technical review functions, with responsibilities including determining coverage and handling customer interactions by phone.

Qualifications

• Pharmacy Technician certification required and preferred for med claims processing.
• Experience with data entry and managed care environments.
• Experience handling Prior Authorization processing workflows.
• Strong customer service skills and ability to manage inquiries and claims.
• Proficient computer skills and familiarity with HIPAA-compliant systems.
• Ability to work independently in a remote/closed-door setting.

Responsibilities

• Handle intake of MedPharm prior authorizations and set up in the system.
• Perform tech review by assessing PA cases for coverage.
• Approve or deny medications based on clinical determinations and eligibility.
• Read and interpret criteria, SOPs, and insurance/medical documents to decide.
• Provide excellent customer service over the phone and manage conversations.

Skills

Pharmacy Technician certification

Data entry & managed care

Prior Authorization processing

Customer service & claims handling

Strong computer skills

Remote work capability

Education

Cpht certification

Job description

Actalent is seeking a dedicated Pharmacy Technician to support Medicare/Medicaid patients, focusing on prior authorizations within a MedPharm environment. This remote role requires strong data-entry skills and HIPAA compliance.

Training and schedule details are provided once onboarded. The position emphasizes intake and technical review functions, with responsibilities including determining coverage and handling customer interactions by phone.