REMOTE Prior Authorization Pharmacy Technician

Pharmacy Technician

We are seeking a dedicated Pharmacy Technician to work with Medicare and Medicaid patients, primarily focusing on prior authorizations. The role involves both intake and technical review functions within the MedPharm environment.

Responsibilities

• Handle the intake of MedPharm prior authorizations, setting them up in the system and forwarding to the review technician.
• Conduct Tech Review by receiving PA cases from the intake team and reviewing them to determine coverage.
• Approve or deny medications based on clinical determinations and eligibility criteria.
• Read and interpret criteria, SOPs, insurance documents, and medical documents to make informed decisions.
• Provide excellent customer service over the phone, managing conversations and redirecting when necessary.

Essential Skills

• Pharmacy Technician certification
• Experience in data entry and managed care
• Prior Authorization processing
• Proficiency in customer service and handling claims
• Strong computer skills
• Ability to work independently and remotely

Additional Skills & Qualifications

• Experience in pharmacy and managed care environments
• Certified Pharmacy Technician (CPHT) certification

Work Environment

This position is 100% remote, requiring a closed-door setting with limited distractions and compliance with HIPAA regulations. Candidates must have strong WiFi connectivity. Training is scheduled Monday to Friday from 10:00 AM to 6:30 PM EST, with holiday rotations. Post-training, the work schedule is Sunday to Thursday or Tuesday to Saturday, with varied hours. Lunch breaks range from 30 minutes to an hour. The workplace culture boasts a high satisfaction score, offering flexibility, paid time off, and benefits.

Job Type & Location

This is a Contract to Hire position based out of Houston, TX.

Pay and Benefits

The pay range for this position is $20.00 - $22.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

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)

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 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing winner for both client and talent service.

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 process due to a disability, please email View email address on click.appcast.io for other accommodation options.

Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.