Pharmacy Technician - REMOTE

About the role

The Pharmacy Technician supports coverage determination and prior authorization activities for Medicare Part D recipients by reviewing requests, gathering clinical information, and documenting decisions in the pharmacy benefit management system. This role works closely with prescribers, providers, and members to ensure timely and accurate processing of coverage determinations while providing clear communication and support throughout the authorization process.

Responsibilities

• Track and triage all coverage determination requests for prior authorizations
• Review coverage determination requests submitted by providers and determine when a pharmacist review is required
• Obtain verbal authorizations from prescribers and request detailed clinical information to support coverage decisions
• Approve coverage determination requests based on defined clinical and plan criteria
• Enter and document coverage determination decisions accurately in the pharmacy benefit management (PBM) system
• Notify providers and members of coverage determination outcomes in a clear and timely manner
• Respond to client inquiries regarding authorization approvals and the use of PBM online applications
• Refer coverage determination requests for specialty medications to the appropriate delegated vendor or client for processing
• Contact providers to obtain additional information needed to complete coverage determination reviews
• Communicate coverage determination decisions to physicians, providers, and members, ensuring they understand the outcome and next steps

Requirements

• Active State or National Pharmacy Technician license
• Pharmacy technician certificate or equivalent credential
• At least 1 year of experience in a retail, hospital, or mail order pharmacy setting
• High school diploma or equivalent
• Experience working in a mail order pharmacy or retail pharmacy environment
• Ability to accurately document information and decisions in a PBM or similar system
• Strong verbal communication skills for obtaining authorizations and clinical details from prescribers
• Ability to interpret and apply defined criteria for coverage determinations and prior authorizations
• Experience with prior authorizations
• Ability to work Monday–Friday, with some weekend work after training; 10am–6:30pm EST during training, 10am–6:30pm your time zone after training

Work Environment

This position operates in a professional pharmacy or pharmacy benefit management environment that relies heavily on computer-based systems and data entry. You will spend most of your time working at a workstation using PBM and related software to process coverage determination requests. The role typically follows structured hours aligned with business operations, with a focus on timely response to provider, member, and client inquiries. The environment emphasizes accuracy, confidentiality, and adherence to regulatory and internal policies. Professional attire appropriate for an office or clinical support setting is expected.

Pay

The pay range for this position is $20.00 – $23.00/hr. Individual compensation offered within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Schedule

Monday–Friday, with some weekend work after training. 10am–6:30pm EST during training; 10am–6:30pm your time zone after training.