REMOTE Certified Pharmacy Technician

Remote Certified Pharmacy Technician

Join a dynamic pharmacy operations team supporting pharmacy benefits, prior authorizations, formulary management, Medicare programs, appeals, and member services. In this role, you will partner with pharmacists, providers, pharmacies, and members to ensure accurate claims processing, regulatory compliance, and exceptional customer service. This position is ideal for a detail-oriented Pharmacy Technician who enjoys problem-solving, working with healthcare data, and making a direct impact on patient access to medications.

Responsibilities

• Process and review pharmacy benefit requests, prior authorizations, formulary updates, and prescription claims in accordance with established guidelines.
• Research and resolve pharmacy-related inquiries from providers, pharmacies, members, and internal business partners.
• Support Medicare Part D, Medicare Part B, and state health program pharmacy operations, including claims processing, audits, and compliance activities.
• Review claim, benefit, and authorization data to identify discrepancies, ensure accuracy, and support quality assurance initiatives.
• Maintain and update pharmacy databases, documentation, reports, and benefit information across multiple systems.
• Collaborate with pharmacists, medical leadership, and cross-functional teams to support clinical and operational pharmacy initiatives.
• Assist with pharmacy audit and recovery activities, including claim reviews, findings documentation, and pharmacy communications.
• Support appeals, coverage determinations, and prior authorization workflows by gathering information, documenting cases, and communicating outcomes.
• Respond to inbound calls, emails, and other correspondence while providing professional customer service and pharmacy benefit education.
• Participate in regulatory, compliance, and process improvement initiatives to support efficient pharmacy operations.
• Perform other duties as assigned to support pharmacy operations and member service.

Essential Skills

• High school diploma or GED required.
• At least 1 year of Pharmacy Technician experience.
• Experience working with prescription claims, prior authorizations, pharmacy benefits, or related pharmacy operations.
• Strong attention to detail with excellent data entry and documentation skills.
• Ability to research, analyze, and resolve issues using established resources and guidelines.
• Strong verbal and written communication skills when interacting with members, providers, pharmacies, and internal teams.
• Ability to manage multiple priorities in a fast-paced environment while maintaining accuracy.
• Proficiency with computer systems, databases, and Microsoft Office applications.
• Customer service experience preferred.
• Valid Pharmacy Technician license preferred.

Additional Skills & Qualifications

• Experience with prior authorizations, formulary management, appeals, pharmacy audits, or pharmacy benefit operations.
• Knowledge of Medicare Part D, Medicare Part B, PBM processes, and pharmacy claims systems.
• Familiarity with state-sponsored healthcare programs and pharmacy benefit administration.
• Experience supporting compliance, audit preparation, or regulatory requirements.
• Ability to collaborate effectively with pharmacists, providers, and cross-functional business teams.
• Strong analytical and problem-solving skills with the ability to interpret pharmacy and medical benefit information.

Work Environment

This position works in a structured office or contact-center setting supporting pharmacy benefit administration and member services. Daily responsibilities include working within pharmacy systems, claims platforms, and reporting tools while managing phone, email, and electronic documentation workflows. Success in this role requires strong attention to detail, adherence to established procedures, and collaboration with internal and external stakeholders in a fast-paced, compliance-focused environment.

Job Type & Location

This is a Contract to Hire position based out of Houston, TX.

Pay and Benefits

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…