Certified Pharmacy Technician

Job Summary

Working remotely on a full-time temporary basis, a Certified Pharmacy Technician will process prior authorization requests, interpret clinical criteria, and manage communications with providers and pharmacies during the review process.

Key responsibilities

• Interprets and applies clinical criteria during the prior authorization review process
• Utilizes member claims history and makes outbound calls to gather necessary information for processing requests
• Submits authorizations to pharmacy and medical claims processors while assisting with appeals as assigned

Required qualifications

• High School Diploma or equivalent
• Certified Pharmacy Technician (PTCB or NHA)
• 1 to 3 years of prior authorization experience or relevant pharmacy experience
• Minimum typing speed of 35 words per minute
• Ability to work shifts outside standard business hours, including weekends and holidays