Senior PBM Pharmacy Technician – Remote Expert Support

Embedded Shishya; United States; Remote; USD 34,000 - 48,000; Full time

Benefits offered by this job

Flexible vacation policy

401(k) employer match

Comprehensive health benefits

Educational assistance

Leadership academies

Job summary

Gainwell Technologies seeks a Senior Certified Pharmacy Technician to join its PBM Clinical and Technical Call Center. You will support members, providers, and pharmacy providers with complex benefits questions and medication access needs, across phone, fax, email, and web platforms.

You will resolve complex inquiries, assist escalated issues, support training, and help ensure accurate, timely service while maintaining high-quality standards in a fully remote environment.

Qualifications

• Active and current Certified Pharmacy Technician (CPhT) credential.
• Minimum of 2 years of call center experience, preferably in a healthcare or PBM environment.
• Minimum of 2 years of PBM experience, including formulary management, pharmacy claims adjudication, and benefit interpretation.
• Strong knowledge of pharmacy claims processing and claim rejection resolution.
• Strong verbal and written communication skills and ability to work across multiple systems.

Responsibilities

• Provide advanced support to members, prescribers, and pharmacy providers via phone, fax, email, and web-based channels.
• Research and resolve complex PBM inquiries including claims, rejections, formulary questions, and medication access issues.
• Coordinate prior authorization processes and ensure requests are handled accurately within guidelines.
• Serve as a subject matter expert, assisting escalated issues and supporting training and onboarding.
• Contribute to quality and process-improvement initiatives while meeting service, productivity, compliance, and CX standards.

Skills

Call center experience

PBM experience

Pharmacy claims

Formulary knowledge

Benefit interpretation

Communication skills

Bilingual (preferred)

Education

Certified Pharmacy Technician (CPhT)

Job description

Gainwell Technologies seeks a Senior Certified Pharmacy Technician to join its PBM Clinical and Technical Call Center. You will support members, providers, and pharmacy providers with complex benefits questions and medication access needs, across phone, fax, email, and web platforms.

You will resolve complex inquiries, assist escalated issues, support training, and help ensure accurate, timely service while maintaining high-quality standards in a fully remote environment.