Job Description
This role involves working as a Pharmacy Technician with Medicare and Medicaid patients, primarily focusing on Medicare. The position requires handling Prior Authorizations through two main functions: intake and tech review. Initially, the role will focus on the intake of medpharm prior authorization, setting up the PA in their systems, and sending it to a review tech. Training will be provided for the tech review, where the technician will receive the PA case from the intake team, review it to determine coverage, and make clinical determinations on medication approvals or denials.
ResponsibilitiesConduct intake of medpharm prior authorizations and set up PA in systems.Send authorizations to review tech for further processing.Receive PA cases from intake team and review coverage criteria.Make clinical determinations on medication approval or denial based on criteria, SOPs, insurance, and medical documents.Read extensively over criteria, SOPs, insurance documents, and medical documents to determine eligibility.Essential SkillsPharmacy Technician certificationExperience in pharmacy and managed careData entry skillsPrior Authorization experienceProficiency in computer skillsAbility to work remotely and independentlyCustomer service skillsCPht certificationAdditional Skills & QualificationsExperience in managed careAbility to handle phone customer serviceCapability to control and redirect conversations as neededWork Environment
This position is 100% remote, requiring work in a closed door setting with limited distractions and compliance with HIPAA regulations. A strong WiFi connection is necessary. The training schedule is Monday to Friday, 10:00 AM to 6:30 PM EST. Post-training, the work schedule offers flexibility with options to work Sunday through Thursday or Tuesday through Saturday. Preferred hours for Sunday through Thursday are 12:00 PM to 8:30 PM or 12:30 PM to 9:00 PM EST, with Sunday from 8:00 AM to 4:30 PM EST. For Tuesday through Saturday, preferred hours are 12:30 PM to 9:00 PM EST, with Saturday from 8:00 AM to 4:30 PM EST. Lunch breaks range from 30 minutes to an hour.
Pay and Benefits
The pay range for this position is $20.00 - $22.00/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 Aug 16, 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 actalentaccommodation@actalentservices.com for other accommodation options.