Job Description

Remote Pharmacy Technician – Prior Authorization

This remote Pharmacy Technician position focuses on reviewing prior authorization requests for prescription medications within a pharmacy services department that supports a large healthcare insurance organization. You will evaluate coverage determination requests for a variety of health plans and medications, approve or deny based on established criteria, and route decisions to pharmacists for final review. The role involves detailed computer-based work in multiple systems, minimal phone interaction, and offers a clear path to long-term, permanent employment with benefits and paid time off.

Responsibilities

• Review prior authorization requests for prescription medications across multiple health plans and drug types.
• Determine coverage eligibility by applying established clinical and benefit criteria to each request.
• Approve or deny prior authorization requests and document decisions accurately in the PBM system.
• Route all decisions to pharmacists for final review and sign-off.
• Track and manage coverage determination requests to ensure timely processing and resolution.
• Obtain verbal authorizations from prescribers and other stakeholders when required.
• Request and collect detailed clinical information from prescribers to support coverage decisions.
• Enter all decisions, notes, and supporting information into multiple computer systems with a high level of accuracy.
• Notify providers and members of decision outcomes in accordance with departmental procedures.
• Respond to client and provider inquiries related to prescription benefit coverage and prior authorization status.
• Refer requests for specialty medications and complex cases to appropriate internal teams or pharmacists.
• Contact providers to obtain additional information needed to complete coverage determinations.
• Assist with inbound and outbound patient or physician calls as needed, primarily outbound and limited in volume.
• Work within established productivity, accuracy, and quality metrics, contributing to a high-performing pharmacy services team.
• Maintain compliance with state pharmacy regulations and organizational policies for pharmacy technicians.
• Use strong customer service skills to communicate clearly and professionally with members, providers, and internal partners.
• Handle sensitive health information responsibly, maintaining confidentiality and data integrity at all times.

Essential Skills

• High school diploma or GED.
• Current registration as a pharmacy technician in the state of residence.
• National certification as a pharmacy technician (PTCB or NHA).
• Active Pharmacy Technician Certification and registration as required by the state of operation.
• Demonstrated experience as a pharmacy technician in environments such as retail pharmacy, hospital pharmacy, specialty pharmacy, PBM, or call center settings.
• Strong computer skills, including proficiency with multiple screens and systems simultaneously.
• Basic to intermediate proficiency with Microsoft Office applications, including Outlook.
• Accurate data entry skills and attention to detail in electronic documentation.
• Customer service experience, particularly in healthcare, pharmacy, or prescription benefits settings.
• Ability to review prior authorization requests and apply coverage criteria accurately.
• Comfort working with prescription benefits, Medicare, and Medicaid-related coverage determinations.
• Ability to work remotely with reliable high-speed Wi-Fi and a dedicated workspace.
• Availability to work Monday through Friday between 8:00 a.m. and 8:00 p.m. in the local time zone, with rotating weekend and some holiday coverage.

Additional Skills & Qualifications

• Experience working in a pharmacy benefits management (PBM) environment.
• Background in retail pharmacy, hospital pharmacy, or specialty pharmacy settings.
• Experience handling prior authorizations, prescription benefits, and health plan coverage determinations.
• Familiarity with call center operations, including handling patient and physician calls.
• Strong organizational skills and the ability to manage a high volume of requests in a fast-paced environment.
• Ability to learn new software platforms and navigate multiple systems efficiently.
• Comfort working with complex benefit structures, including Medicare and Medicaid plans.
• Demonstrated reliability and consistency in meeting performance metrics and quality standards.
• Interest in building a long-term career in a nationwide healthcare organization with opportunities for growth.
• Professional communication skills, both written and verbal, with attention to clarity and accuracy.

Work Environment

This is a professional remote work environment where you perform pharmacy technician duties from your home office. You will work primarily on a computer using multiple monitors, navigating several pharmacy and PBM systems, Microsoft Office tools, and email applications. The role involves minimal phone work, with occasional outbound calls to prescribers, patients, or physicians as needed. You must have strong, reliable Wi-Fi, a private workspace with a closed door to maintain confidentiality, and a smartphone for communication and authentication needs. The organization provides core equipment, including a computer, monitor, and headset. Training is conducted remotely on an 10:00 a.m. to 6:30 p.m. EST schedule, after which you transition to a regular shift. You must be available Monday through Friday between 8:00 a.m. and 8:00 p.m. in your local time zone, with participation in a rotating weekend schedule approximately every 4–6 weeks and some holiday coverage. Work schedules are published three months in advance, and there is potential for schedule flexibility based on performance metrics and tenure. The environment emphasizes professionalism, accuracy, and adherence to performance standards, and offers the opportunity to transition to a permanent role with benefits and paid time off as part of a nationwide healthcare organization.

Job Type & Location

This is a Contract to Hire position based out of Dallas, Texas.

Pay and Benefits

The pay range for this position is $20.00 - $23.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

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 Sep 28, 2026.

Job Tags

Permanent employment, Contract work, Temporary work, Work at office, Local area, Remote work, Home office, Monday to Friday, Shift work

Similar Jobs