Remote Pharmacy Technician

Remote Pharmacy Technician!

This role offers an opportunity for a licensed Pharmacy Technician to support the appeals process for Medicare and Medicaid members, with a primary focus on Medicare. You will review denied prior authorization requests, gather additional clinical or administrative information as needed, and prepare complete case files for pharmacists to make final coverage determinations. The position centers on outbound phone-based customer service with members who may be frustrated about medication denials, requiring strong communication skills, empathy, and the ability to manage conversations effectively while maintaining accuracy in documentation and data entry.

Responsibilities

• Review denied prior authorization cases for Medicare and Medicaid members, with a primary focus on Medicare appeals.

• Evaluate information provided in each case to determine what additional details are needed to support the appeal.

• Make 30-60 outbound calls per shift to members and other relevant parties to obtain missing or clarifying information.

• Communicate clearly and empathetically with Medicare and elderly members who may be frustrated about medication denials.

• Ask targeted questions and control the conversation to keep calls focused and productive while maintaining a professional and supportive tone.

• Gather and document clinical and administrative details related to medications, including injectable therapies administered in a doctor's office.

• Accurately enter and update case information in the appropriate systems and databases.

• Prepare complete and organized case files and forward them to pharmacists for final determination on whether to uphold or overturn denials.

• Follow established appeals procedures, guidelines, and timelines to ensure efficient and compliant case handling.

• Collaborate with pharmacists and other team members as needed to clarify case details and support timely decision-making.

Required Skills

• Active pharmacy technician license.

• Experience working in a pharmacy or managed care environment.

• Knowledge of pharmacy operations, medication terminology, and prior authorization processes.

• Familiarity with appeals, managed care, claims, and denial workflows.

• Strong customer service skills over the phone, including the ability to handle difficult or emotional conversations.

• Ability to control and guide conversations and redirect discussions when necessary.

• Proficiency in accurate and efficient data entry.

• Strong attention to detail and ability to review and interpret case information.

• Clear verbal communication skills and professional telephone etiquette.

Remote role: Preferably located at South Carolina/Arizona/Florida/Alabama/Texas/Florida

INTERESTED IN THIS ROLE? SEE BELOW TO BE IMMEDIATELY CONSIDERED:

• I am scheduling phone interviews as early as today. All candidates will be considered immediately within 24 hours of applying directly to Fathima

• HOW TO APPLY DIRECTLY: Email your updated resume, brief intro about your interest, preferred method of communication for you (i.e., call, email, text) to View email address on click.appcast.io (View email address on click.appcast.io) or CALL- View phone number on click.appcast.io

Job Type & Location

This is a Contract to Hire position based out of Miami, FL.

Pay and Benefits

The pay range for this position is $18.00 - $20.00/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 7, 2026.

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.

San Francisco Fair Chance Ordinance: 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.

Massachusetts Lie Detector: 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.

Use of Artificial Intelligence (AI): 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.