Prior Authorization Pharmacy Technician (Remote)

Remote Pharmacy Technician

As a Pharmacy Technician, you will play a crucial role in reviewing Prior Authorizations for coverage determination within a Pharmacy Services department at a large healthcare insurance company. Your responsibilities include approving or denying requests and forwarding them to a Pharmacist for final review. The role involves handling all health plans and various types of medications with minimal phone work, primarily outbound calls.

Responsibilities

• Track coverage determination requests and obtain verbal authorizations.
• Approve requests based on established criteria.
• Enter decisions into the Pharmacy Benefit Management (PBM) system.
• Notify providers and members of decision outcomes.
• Respond to client inquiries and refer requests for specialty drugs.
• Contact providers for additional information.
• Notify stakeholders of decision outcomes.
• Assist with inbound and/or outbound patient or physician calls, if needed.

Essential Skills

• High School diploma or equivalent.
• Current Pharmacy Registration and Certification as required by the state of operation.
• Strong computer skills including proficiency in Microsoft Office and data entry.
• Experience with prior authorization, Medicare, and Medicaid.

Additional Skills & Qualifications

• National certification as a Pharmacy Technician (NHA, PTCB).
• Experience in retail pharmacy, call center, hospital, or specialty pharmacy settings.
• Registered and certified pharmacy technician status.

Work Environment

This is a professional remote environment where you will work across multiple screens and systems. You must have strong Wi-Fi and a dedicated office space with a closed door. The work schedule requires flexibility, with availability Monday through Friday from 8am to 8pm in your local time zone, and rotating weekends every 4-6 weeks. Some holiday work is required, with schedules sent three months in advance. Equipment such as a computer, monitor, and headset will be provided. Training will occur from 10am to 6:30pm EST, after which you will transition to your regular shift.

Job Type & Location

This is a Contract to Hire position based out of Cleveland, OH.

Pay and Benefits

The pay range for this position is $20.00 - $23.00/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 8, 2026.