Job Description
We are seeking a dedicated Pharmacy Technician to join our team, focusing on supporting Medicare and Medicaid patients through the prior authorization process. This role involves two primary functions: intake and technical review. Initially, you will manage the intake of prior authorizations, setting up cases in our system before forwarding them for review. You'll also receive training for tech review, where you'll assess coverage criteria, approve or deny authorizations, and make clinical determinations based on insurance and medical documents.
ResponsibilitiesHandle intake of prior authorization requests, setting up cases in the system.Conduct technical reviews to determine coverage eligibility.Approve or deny medication coverage based on clinical criteria.Read and interpret criteria, SOPs, insurance documents, and medical records.Provide excellent customer service and manage communications effectively.Work independently and remotely, ensuring HIPAA compliance.Essential SkillsPharmacy technician certification.Prior experience in managed care and claims processing.Proficient in data entry and computer skills.Ability to work remotely and independently.Strong customer service skills.Additional Skills & QualificationsExperience handling customer service calls.Ability to control and redirect conversations as needed.Work Environment
This position is 100% remote, requiring a closed-door setting with limited distractions and HIPAA compliance. A strong WiFi connection is essential for remote work.
Pay and BenefitsThe 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 21, 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.