"Alerted.org

Job Title: Remote Pharmacy Technician

Job Description

As a Pharmacy Technician, you will play a vital role in tracking and triaging coverage determination requests submitted by providers. Your responsibilities will include obtaining verbal authorizations, requesting detailed clinical information from prescribers, and approving coverage determination requests based on defined criteria. You will enter and document these decisions into the Pharmacy Benefits Management (PBM) system and notify providers and members accordingly. Additionally, you will respond to client inquiries regarding authorization approvals and assist with PBM online applications.

Responsibilities

+ Track and triage coverage determination requests for prior authorizations and Medicare Part D recipients.

+ Determine if a pharmacist review is required for coverage determination requests.

+ Obtain verbal authorizations and request detailed clinical information from prescribers.

+ Approve coverage determination requests based on defined criteria.

+ Enter and document coverage determination request decisions into the PBM system.

+ Notify providers and members of coverage determination request decisions.

+ Respond to client inquiries regarding authorization approvals and PBM online applications.

+ Refer coverage determination requests for specialty drugs to delegated vendors or clients for processing.

+ Contact providers for additional information to facilitate coverage determination reviews.

Essential Skills

+ High school diploma or equivalent.

+ 1+ years of experience in retail, hospital, or mail-order pharmacy.

+ Current state Pharmacy Technician license.

+ National Certification from the Pharmacy Technician Certification Board (CPhT).

Additional Skills & Qualifications

+ Experience in data entry and customer service.

+ Knowledge of prior authorization processes.

+ Experience in call center operations and health care.

+ Troubleshooting skills and familiarity with retail pharmacy and insurance billing.

Work Environment

This position offers the flexibility to work remotely, with candidates preferred from Arizona, Georgia, or North Carolina, although candidates can sit anywhere. The role is contract-based, with an 8-hour shift starting between 8 am and 10 am EST, including a one-hour lunch break. The work involves interacting with the PBM system and handling inquiries regarding authorization approvals. The environment fosters a collaborative approach to managing coverage determination requests efficiently.

Pay and Benefits

The pay range for this position is $20.00 - $21.00/hr.

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)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Jun 19, 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.

The 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.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email [email protected] (%[email protected]) for other accommodation options.