Remote Pharmacy Technician

We are hiring Pharmacy Technicians for the Appeals department. This role involves handling medical authorizations, primarily for injectables administered at doctor's offices, rather than traditional prescription authorizations.

The position is largely data entry-focused with some outbound phone work to call doctors or members.

You will review rejected Prior Authorizations that have gone to appeal, gather necessary information, and manage both inbound and outbound communication with healthcare providers and members.

Responsibilities

• Review rejected Prior Authorizations that have gone to appeal.
• Perform data entry tasks, including building/intaking appeals or reimbursement requests into the Compass system.
• Access and manage the department's inbound fax queue.
• Review Pharmacy Appeals or Reimbursement cases against plan criteria.
• Make outreach calls to provider offices and members to obtain additional information needed for case reviews.
• Handle inbound calls from doctors' offices and members seeking further information.

Essential Skills

• Customer service experience
• Prior authorization knowledge
• Insurance understanding
• Data entry proficiency
• Computer skills
• Proficiency in Microsoft Office suite, including Microsoft Outlook
• Quality auditing and intake capabilities
• Valid Pharmacy Technician License
• Ability to work independently

Additional Skills & Qualifications

• 2 years of experience in retail, payor, or hospital settings
• Strong attention to detail
• Adaptability to change
• Registration and national certification as a Pharmacy Technician
• Experience with managed care or prior authorization is a plus
• Ability to meet tight turnaround times and compliance deadlines

Work Environment

This is a 100% remote position, requiring a quiet and closed-door setting with a strong Wi-Fi connection. The work schedule is Monday to Friday, 8am-8pm in your time zone, with most shifts likely being 10am-6:30pm after training. There will be weekend rotations approximately every 4-6 weeks, and occasional holiday work may be required. Training lasts for 4 weeks, Monday to Friday, from 10am-6:30pm EST.

Pay and Benefits

The pay range for this position is $18.00 - $20.00

• 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 will be accepting applications until Dec 10, 2024.

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 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

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 actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $18 - $20