Pharmacy Technician - Remote

Remote Pharmacy Technician

This role focuses on tracking and triaging coverage determination requests for prior authorizations, primarily for Medicare Part D recipients. The Pharmacy Technician I supports the pharmacy benefit management process by reviewing requests, gathering clinical information, and documenting decisions in the pharmacy benefit management (PBM) system while providing clear communication to providers, members, and internal stakeholders.

Responsibilities

• Track and triage coverage determination requests submitted by providers for prior authorizations, particularly for Medicare Part D recipients.
• Review incoming coverage determination requests and determine whether a pharmacist's clinical review is required based on established guidelines.
• Obtain verbal authorizations from prescribers and request detailed clinical information needed to support coverage determination decisions.
• Approve coverage determination requests in accordance with defined criteria and organizational policies.
• Accurately enter and document coverage determination decisions in the PBM system, ensuring all required information is complete and up to date.
• Notify providers and members of coverage determination decisions in a timely and professional manner.
• Respond to client inquiries regarding authorization approvals and PBM online processes, providing clear and accurate information.
• Refer coverage determination requests for specialty medications to the appropriate delegated vendor or client for processing, following established workflows.
• Contact providers to obtain additional information when needed to facilitate thorough and accurate coverage determination reviews.
• Communicate coverage determination outcomes to physicians, providers, and members, ensuring they understand the decision and any next steps.

Essential Skills

• High school diploma or equivalent.
• At least 5 year of experience in a retail or prior authorization experience
• Current state Pharmacy Technician license.
• Current PTCB license

Work Environment

This position operates in a professional pharmacy or pharmacy benefit management office environment that is focused on processing coverage determinations efficiently and accurately. Work typically involves extensive use of computers and PBM or related healthcare information systems for data entry, documentation, and communication. The role requires frequent phone and electronic communication with providers, members, and clients. The schedule generally follows standard business hours, with expectations to manage workloads and respond promptly to incoming requests and inquiries. Attire is professional and appropriate for an office-based healthcare setting.

Job Type & Location

This is a Contract position based out of San Antonio, TX.

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 Jun 16, 2026.