Pharmacy Technician

Job Title:

Pharmacy Technician

Job Description

This Pharmacy Technician role focuses on tracking and triaging coverage determination requests for prior authorizations and Medicare Part D recipients. You will support the clinical review process by gathering information from providers, applying defined criteria to approve requests when appropriate, and ensuring accurate documentation in the pharmacy benefit management (PBM) system. This position plays a key role in delivering timely and accurate coverage decisions to prescribers and members.

Responsibilities

+ Track and triage all coverage determination requests submitted by providers for prior authorizations and Medicare Part D recipients.

+ Review incoming coverage determination requests and determine when a pharmacist review is required based on established guidelines.

+ Obtain verbal authorizations from prescribers and request detailed clinical information needed to complete coverage determinations.

+ Apply defined criteria to approve coverage determination requests within the scope of the role.

+ Enter and document all coverage determination request decisions accurately in the PBM system.

+ Notify providers and members of coverage determination decisions in a clear and timely manner.

+ Respond to client inquiries regarding authorization approvals and PBM online processes.

+ Refer coverage determination requests for specialty drugs to the appropriate delegated vendor or client for processing.

+ Contact providers to obtain any additional information required to facilitate coverage determination reviews.

+ Communicate coverage determination decisions to physicians, providers, and members while maintaining professionalism and accuracy.

Essential Skills

+ High school diploma or equivalent.

+ At least 1 year of experience in a retail, hospital, or mail order pharmacy setting.

+ Current state Pharmacy Technician license.

+ Experience handling prior authorization or coverage determination processes in a pharmacy environment.

+ Ability to track and triage multiple coverage determination requests efficiently.

+ Skill in obtaining verbal authorizations and detailed clinical information from prescribers.

+ Proficiency in entering and documenting decisions in a PBM or similar pharmacy system.

+ Strong attention to detail and accuracy in documentation and communication.

+ Clear and professional verbal and written communication skills for interacting with providers, members, and clients.

+ Ability to follow defined criteria and established procedures when approving coverage determinations.

Additional

Skills & Qualifications

+ National Certification from the Pharmacy Technician Certification Board (CPhT) is preferred.

+ Experience working with Medicare Part D coverage determinations is a plus.

+ Familiarity with PBM systems and online authorization platforms.

+ Ability to manage time effectively in a fast-paced environment.

+ Strong organizational skills and the ability to prioritize multiple requests.

+ Customer service mindset with a focus on supporting providers and members.

Work Environment

This role operates in a structured pharmacy benefit management environment that may be office-based or within a centralized pharmacy operations setting. You will work extensively with PBM systems, online authorization tools, and electronic documentation to process coverage determination requests. The position typically follows standard business hours, with potential variations depending on operational needs. The work involves frequent phone and electronic communication with prescribers, providers, clients, and members, requiring a professional and courteous demeanor at all times.

The environment emphasizes accuracy, confidentiality, and adherence to pharmacy regulations and internal procedures.

Job Type & Location

This is a Contract position based out of Chicago, IL.

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,…