REMOTE Prior Authorization Pharmacy Technician

As a Remote Prior Authorization Review Pharmacy Technician, you will perform duties in various areas including Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D/Part B, Appeals, Medicare Part D Operations, and State Health Programs Pharmacy Operations. You will review requests made by physicians, medical groups, pharmacies, and members for the use of prescription drugs and pharmacy benefits. Your role involves researching and resolving questions, problems, or issues and consulting with Clinical Pharmacists or Regional Medical Directors as needed.

Responsibilities

• Train on Intake and Technician Review processes.
• Accurately type information on the prior authorization request form into a Compass case.
• Verify intake accuracy and compare prior authorization requests with clinical documentation to determine approval.
• Contact the office for any missing information required for request approval.
• Route denials to the pharmacist queue for double-checking.
• Remediate cases if determinations need overturning or errors need correction.
• Move cases to the Manual Outreach queue and communicate decisions to providers and/or members.

Requirements

• Pharmacy Technician license.
• 2 years of experience as a Pharmacy Technician.
• Experience with managed care and claims.
• Proficiency in data entry.

Skills

• Customer service or retail experience preferred.
• Familiarity with Microsoft functions including Teams, Outlook, Word, Excel, and OneNote.

Work Environment

This position is fully remote, fostering a strong sense of connectivity and support through Teams for chat, audio or video calls, and screen shares. Outlook is heavily used for team communications.

Schedule

The training schedule is Monday-Friday from 10am to 6:30pm. Post-training, the schedule will be Tuesday-Friday from 12:30pm to 9pm EST and Saturday from 8am to 4:30pm EST. Overtime is not expected.

Pay

The pay range for this position is $18.00 - $22.00/hr.

Benefits

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• 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)

This is a Contract to Hire position based out of St. Louis, MO.