Senior Pharmacy PA & Appeals Specialist (Remote)

Optum; Portland (ME); On-site; USD 25,000 - 44,000; Full time

Benefits offered by this job

Paid Time Off

Medical plan

401k plan

Job summary

Optum is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals, handling requests through multiple channels and ensuring accuracy, compliance, and timely processing.

The role requires pharmacy technician licensure, PTCB/ExCPT certifications, and 6+ months of relevant experience, with a Monday–Friday 8am–8pm EST schedule and possible weekend on-call in Maine or Vermont.

Qualifications

• Active and unrestricted Pharmacy Technician licensure in state of residence.
• PTCB certification.
• ExCPT certification.
• 6+ months of experience in customer service or healthcare.
• Strong attention to detail and accuracy.

Responsibilities

• Handle prior authorization requests via phone, fax, and electronic systems.
• Research formulary and benefit information to support approvals.
• Document calls and decisions in the appropriate systems with accuracy.
• Coordinate with pharmacists for clinical review when needed.
• Meet turnaround times and comply with SLAs.

Skills

Pharmacy licensure

PTCB

ExCPT

Prior authorization experience

Communication

Tools

Excel

Job description

Optum is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals, handling requests through multiple channels and ensuring accuracy, compliance, and timely processing.

The role requires pharmacy technician licensure, PTCB/ExCPT certifications, and 6+ months of relevant experience, with a Monday–Friday 8am–8pm EST schedule and possible weekend on-call in Maine or Vermont.