Job Description
Pharmacy technicians are sought to work in the EST Timezone. This role involves reviewing Prior Authorizations for coverage determination for a department that is part of a large healthcare insurance company. Technicians must either approve or deny requests and then send them to pharmacists for final review. The role requires handling all health plans and all types of medications with minimal phone work, mostly outbound if any.
ResponsibilitiesTrack coverage determination requests.Obtain verbal authorizations and request detailed clinical information from prescribers.Approve or deny requests based on criteria and enter decisions into the PBM system.Notify providers and members of decision outcomes.Respond to client inquiries.Refer requests for specialty drugs.Contact providers for additional information.Assist with inbound and/or outbound patient or physician calls if needed.Essential SkillsHigh School diploma or equivalent.Current Pharmacy Registration and Certification as required by the state of operation.Basic computer skills.Strong computer skills including proficiency in Microsoft Office and Outlook.Registered Pharmacy Technician license (RPHT, CPHT).Certified Pharmacy Technician (PTCB, NHA).Experience with prior authorization processes.Experience in data entry, customer service, and working within a PBM system.Additional Skills & QualificationsExperience in a retail pharmacy, hospital, or specialty pharmacy setting.Familiarity with Medicare, Medicaid, and insurance processes.Experience in a call center environment.Work Environment
This is a remote position. You will work in a professional environment, utilizing multiple screens and systems. A strong WiFi connection and a dedicated office space with a closed door are required. The shift is Monday-Friday from 8 AM to 8 PM in your local time zone, with rotating weekends every 4-6 weeks and some holidays. Training is from 10 AM to 6:30 PM EST, after which regular shifts will be assigned. Schedules are provided three months in advance. Equipment such as a computer, monitor, and headset will be provided.
Pay and Benefits
The pay range for this position is $18.00 - $20.00/hr.
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Feb 22, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & InclusionAt Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
Hiring diverse talent Maintaining an inclusive environment through persistent self-reflection Building a culture of care, engagement, and recognition with clear outcomes Ensuring growth opportunities for our peopleThe company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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