REMOTE Prior Authorization Pharmacy Technician

Job Description

Job Description

The Prior Authorization Pharmacy Technician is responsible for supporting members, providers, and pharmacies by processing prior authorization requests for prescription medications while ensuring excellent customer service, accuracy, and compliance with regulatory requirements. The Pharmacy Technician will answer inbound calls (up to 50 to 70 calls per day) from providers/members and electronic inquiries related to prior authorizations (PAs) with a high level of professionalism, empathy, and customer service. Demonstrate the ability to accurately capture and verify information provided by prescribers, members, and pharmacies to support timely and compliant medication access decisions. This role involves receiving and reviewing authorization requests via phone, fax, and electronic systems, gathering and verifying clinical information, documenting interactions, evaluating requests against coverage criteria and benefit plans, and collaborating with pharmacists to support coverage determinations. The technician manages a high-volume workload, prioritizes requests based on service level agreements and turnaround times, maintains accurate records, resolves coverage-related issues, and communicates effectively with providers, members, pharmacies, and internal teams to facilitate timely access to medications and positive patient outcomes. This position will take incoming requests for prior authorizations, for formulary and non-formulary medications (this can include Commercial, Part D, High Touch Clients, Community and State cliental, Adherence and Monitoring and Prior Authorization Clinical Appeals), while ensuring a high level of customer service and maximizing productivity. Requests can be received via fax or telephone, from providers' offices and pharmacists. The position provides clinical review for authorizations in keeping with legal and contractual requirements, including but not limited to turn around times (TATs) and service level agreements (SLAs). The technician must provide the information clearly, accurately and in a professional manner. Interactions with callers must be documented per contractual and various regulatory / legal requirements.

• Requirements:
• • Active National (PTCB) and/or State Board of Pharmacy Technician Licensure
  • 6+ months of customer service/customer relations experience with healthcare professionals
  • Proficiency with Microsoft Excel, Word, Outlook, and general PC navigation
  • Strong communication, documentation, and multitasking skills
• Duration: 6 Month Contract
• Location: Remote
• Day-to-Day:
• • Process prior authorization requests for prescription medications
  • Handle high-volume inbound calls (50–70 calls per day) from providers, members, and pharmacies
  • Review and document authorization requests received via phone, fax, and electronic systems
  • Verify clinical and coverage information to support medication access decisions
  • Collaborate with pharmacists and internal teams to ensure timely coverage determinations
  • Maintain compliance with regulatory requirements, turnaround times (TATs), and service level agreements (SLAs)
  • Provide exceptional customer service while managing a fast-paced workload