Certified Pharmacy Technician

Job Title: Remote Pharmacy Technician Prior Authorization (EST Time Zone)

Job Description

This remote Pharmacy Technician role focuses on reviewing prior authorization requests and supporting coverage determinations for a large pharmacy services department within a health insurance organization. You will evaluate medication coverage requests for a variety of health plans and drug types, document decisions in pharmacy benefit systems, and collaborate closely with pharmacists, prescribers, and internal teams. This position offers a long-term career path, the potential to convert to a permanent role, and access to benefits and paid time off upon permanent hire.

Responsibilities

• Review prior authorization requests for prescription medications across multiple health plans and drug types, ensuring each request is complete and aligned with established criteria.
• Determine whether to approve or deny coverage requests based on defined guidelines and criteria, and forward all decisions to a pharmacist for final review.
• Track coverage determination requests from receipt through final decision, ensuring timely and accurate processing.
• Enter all coverage decisions and supporting information into the pharmacy benefit management (PBM) system with a high level of accuracy and attention to detail.
• Obtain verbal authorizations from prescribers or their offices when required to complete prior authorization or coverage determination processes.
• Request and collect detailed clinical information from prescribers to support coverage decisions, including diagnosis details, prior therapy information, and other relevant clinical data.
• Notify providers, members, and other stakeholders of approval or denial decisions in a clear, professional, and timely manner.
• Respond to client and internal inquiries related to coverage determinations, prior authorizations, and prescription benefits, escalating or referring issues as appropriate.
• Refer requests for specialty drugs and complex therapies to the appropriate internal teams or pharmacists according to established procedures.
• Contact providers or their offices to clarify prescriptions, obtain missing information, or resolve questions that impact coverage decisions.
• Assist with inbound and outbound patient or physician calls when needed, focusing primarily on outbound communication with minimal inbound phone work.
• Use multiple computer systems, screens, and applications simultaneously to review requests, document decisions, and communicate with stakeholders.
• Maintain accurate, compliant documentation of all actions taken on each prior authorization or coverage determination request.
• Adhere to all regulatory, compliance, and company policies related to pharmacy practice, prescription benefits, and patient information.
• Meet or exceed performance metrics and productivity standards, including turnaround times, quality targets, and accuracy expectations.
• Collaborate with pharmacists and other team members to resolve complex cases and ensure consistent application of coverage criteria.
• Provide excellent customer service to providers, members, and internal partners by communicating clearly, professionally, and respectfully.
• Participate in scheduled training sessions and ongoing education to stay current with policies, systems, and coverage criteria.
• Support a positive, professional remote work culture by being reliable, punctual, and engaged during scheduled shifts.

Essential Skills

• High school diploma or GED.
• Current registration as a pharmacy technician in the state of residence.
• National certification as a pharmacy technician (such as PTCB or NHA).
• Current pharmacy registration and certification as required by the state of operation.
• Experience as a pharmacy technician in settings such as remote, hospital pharmacy, specialty pharmacy, PBM, or call center environments.
• Demonstrated experience with prior authorization processes or coverage determinations in a pharmacy or prescription benefits setting.
• Strong computer skills, including proficiency with basic computer operations and multitasking across multiple screens and systems.
• Proficiency with Microsoft Office applications, including Outlook.
• Accurate and efficient data entry skills.
• Ability to handle prescription benefits information and PBM systems accurately and confidentially.
• Strong customer service skills, with the ability to communicate clearly and professionally with providers, members, and colleagues.
• Ability to work scheduled shifts Monday through Friday between 8:00 a.m. and 8:00 p.m. in the local time zone, including participation in a rotating weekend schedule and some holidays.
• Reliable high-speed Wi-Fi and a private workspace with a door suitable for confidential remote work.
• Ability to learn and follow detailed coverage criteria and apply them consistently to prior authorization requests.
• Strong attention to detail and ability to maintain accuracy in a high-volume, fast-paced environment.

Additional Skills & Qualifications

• PTCB certification (Certified Pharmacy Technician) or NHA certification (National Healthcare Association) for pharmacy technicians.
• Experience working with Medicare and Medicaid prescription benefits.
• Experience in retail pharmacy, hospital pharmacy, specialty pharmacy, or PBM environments.
• Experience in a call center or high-volume customer service setting.
• Familiarity with prescription benefit structures and terminology, including formularies, coverage determinations, and prior authorizations.
• Strong organizational skills and the ability to manage multiple tasks and requests simultaneously.
• Comfort working with minimal phone interaction while focusing on system-based work and documentation.
• Motivation to pursue a long-term career opportunity with potential for permanent employment, benefits, and PTO.
• Ability to meet performance metrics and demonstrate reliability, which can support access to schedule flexibility over time.

Work Environment

This role operates in a fully remote, professional environment aligned with Eastern Standard Time. Training runs from 10:00 a.m. to 6:30 p.m. EST, after which you transition to your regular schedule. 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 46 weeks and the ability to work some holidays. Schedules are published approximately three months in advance, and flexibility may be offered based on performance, metrics, and tenure. You will work on multiple computer screens and within several systems simultaneously, focusing primarily on system-based tasks with limited phone work, mostly outbound calls. The company provides equipment, including a computer, monitor, and headset, while you supply reliable high-speed Wi-Fi, a private workspace with a closed door, and a smartphone. The environment emphasizes professionalism, accuracy, and confidentiality, with opportunities for long-term career growth and potential conversion to a permanent role that includes benefits and paid time off.

This is a Contract to Hire position based out of ORLANDO, FL.

The pay range for this position is $20.00 - $24.00/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)

This is a Contract to Hire position based out of ORLANDO, FL.

This position is anticipated to close on Oct 29, 2026.

This is a fully remote position.

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 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

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.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.