Remote Pharmacy Technician - Prior Authorization

Pharmacy Technician

The Pharmacy Technician supports pharmacy operations including prior authorizations, formulary management, claims processing, audit/recovery, and Medicare Part D/Part B programs. This role partners with pharmacists, providers, and members to ensure accurate, compliant, and timely handling of pharmacy benefits.

Responsibilities

• Review and process prescription drug and pharmacy benefit requests in accordance with guidelines
• Support prior authorizations, coverage determinations, and appeals processing
• Research and resolve issues related to claims, benefits, and formulary coverage
• Maintain and update formulary data, including change requests and audits
• Perform pharmacy audit and recovery activities, including claim discrepancy review
• Communicate with providers, pharmacies, and members via phone, fax, and email
• Document activities accurately in claims systems and databases
• Assist with Medicare Part D/Part B operations and state health programs (e.g., Medi-Cal)
• Support compliance, reporting, and audit readiness activities
• Collaborate cross-functionally to resolve operational and regulatory issues

Essential Skills

• High school diploma or GED
• 1+ year of Pharmacy Technician experience
• Experience with data entry, claims processing, and/or prior authorizations
• Strong attention to detail and problem-solving skills
• Ability to interpret pharmacy benefits, formularies, and guidelines
• Excellent communication and customer service skills
• Ability to manage high-volume workload and multiple priorities

Additional Skills & Qualifications

• Active Pharmacy Technician license
• Experience with Medicare Part D/Part B or state programs (e.g., Medi-Cal)
• Experience in appeals, audit/recovery, or PBM systems
• Experience with databases (e.g., Access)

Work Environment

Fast-paced, structured healthcare environment (office or call center) requiring frequent system use, high accuracy, and collaboration across teams to support pharmacy operations and compliance.

Job Type & Location

This is a Contract to Hire position based out of Tyler, 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 Jul 1, 2026.