Job Description

Job Title: Pharmacy Technician I Prior Authorization

Job Location: 100% Remote

Job Duration: 12 Months



Summary:
The Pharmacy Technician I Prior Authorization will provide professional and courteous support to members, providers, pharmacies, and other callers throughout the prior authorization process. The role involves handling high-volume inbound calls, processing and documenting prior authorization requests, and ensuring accurate and timely completion of reviews based on established criteria. Clinical questions, escalations, and judgment-based decisions will be transferred to the pharmacist team.



Responsibilities:

• Handle high-volume inbound calls from providers, pharmacies, members, and other healthcare stakeholders.
• Provide professional and courteous customer service while assisting callers with prior authorization inquiries.
• Process prior authorization requests using established criteria and procedures.
• Maintain complete, accurate, and timely documentation of prior authorization reviews, approvals, and denials.
• Escalate clinical questions, complex cases, and judgment calls to the pharmacist team.
• Process prior authorization requests received through fax and online portals.
• Make outbound calls as required to obtain or provide information.
• Monitor and respond to department mailboxes and other inquiries.
• Navigate multiple computer systems simultaneously while handling calls and documenting information.
• Utilize MS Teams, Outlook, Word, Excel, and other computer applications.
• Perform additional administrative and pharmacy-related duties as assigned by leadership.
• Maintain confidentiality and work within HIPAA requirements while working remotely.

Experience:

• Minimum 1 year of high-volume inbound call center experience ; healthcare, insurance, PBM, pharmacy, or medical-office experience preferred.
• Pharmacy Technician experience preferred , particularly experience supporting administrative or prior authorization functions.
• Active Pharmacy Technician license, certification, or trainee license preferred but not required.
• Prior Authorization experience is strongly preferred.
• Strong customer service, verbal communication, and written communication skills.
• Advanced computer and data-entry skills with the ability to multitask across multiple systems.
• Proficiency with MS Teams and Outlook required ; working knowledge of Word and Excel preferred.
• Must be comfortable working remotely with a private HIPAA-compliant workspace.
• Must have a hardwired internet connection with minimum speeds of 25 Mbps download / 3 Mbps upload.
• Must be available for approximately six weeks of training, Monday Friday, 8:00 AM 4:30 PM CST .
• After training, must be available for an assigned 8-hour Monday Friday shift between 8:00 AM CST and 12:00 AM CST , with potential weekend requirements.

Candidates must meet all requirements below:

• Hardwired internet connection required (Wi-Fi only is not acceptable)
• Internet speed test screenshot required with submission
• Minimum 25 Mbps download and 3 Mbps upload
• Private, HIPAA-compliant workspace required
• Ability to work on a computer for the duration of the shift
• Smartphone required for use of the PING application

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Job Tags

Traineeship, Work at office, Remote work, Monday to Friday, Shift work, Weekend work

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