Remote Pharmacy Technician

Remote Pharmacy Technician - Prior Authorization (EST Time Zone)

Job Description

This remote Pharmacy Technician role focuses on reviewing prior authorization requests and making coverage determinations for a pharmacy services department within a large health insurance organization. You will evaluate requests for a wide range of medications and health plans, document decisions in the pharmacy benefit management (PBM) system, and collaborate closely with pharmacists for final review. This position offers limited phone work, long-term career potential, and the opportunity to transition to a permanent role with benefits.

Responsibilities

• Review prior authorization requests for prescription medications across multiple health plans and drug types.
• Apply established clinical and coverage criteria to determine whether to approve or deny prior authorization requests.
• Forward all coverage determinations to a pharmacist for final review and sign-off.
• Track and manage coverage determination requests to ensure timely processing and resolution.
• Enter all decisions and supporting information accurately into the PBM system and other internal platforms.
• Obtain verbal authorizations from prescribers and other stakeholders as needed.
• Request and collect detailed clinical information from prescribers to support coverage determinations.
• Notify providers, members, and other stakeholders of decision outcomes in a clear and timely manner.
• Respond to client inquiries related to prescription benefits, prior authorizations, and coverage decisions.
• Refer requests involving specialty medications or complex cases to the appropriate specialty pharmacy or internal team.
• Contact providers for additional information or clarification when documentation is incomplete or unclear.
• Assist with inbound and outbound patient or physician calls when needed, with an emphasis on outbound communication.
• Handle prescription benefit-related questions and issues in a professional, customer-focused manner.
• Use multiple computer systems and screens simultaneously to research cases, document actions, and update records.
• Maintain accurate, detailed records of all interactions, decisions, and supporting documentation.
• Meet productivity, quality, and accuracy metrics while adhering to all applicable policies and procedures.
• Participate fully in remote training sessions, apply learned processes, and adapt to updates in workflows or criteria.
• Protect confidential member and provider information and follow all applicable privacy and security guidelines.

Essential Skills

• High school diploma or GED.
• Current registration as a pharmacy technician in the state of residence.
• National certification as a pharmacy technician (e.g., PTCB or NHA).
• Current Pharmacy Registration and Certification as required by the state of operation.
• Experience working as a pharmacy technician in retail, hospital, PBM, call center, or specialty pharmacy environments.
• Demonstrated experience with prior authorization processes and coverage determinations for prescription benefits.
• Strong computer skills, including proficiency with basic computer operations and data entry.
• Proficiency with Microsoft Office applications, including Outlook.
• Ability to work effectively with multiple screens and systems simultaneously.
• Strong attention to detail and accuracy in reviewing clinical information and entering data.
• Effective customer service skills for interacting with providers, members, and internal teams.
• Ability to work Monday-Friday between 8:00 a.m. and 8:00 p.m. in the local time zone, with rotating weekend and some holiday coverage.
• Reliable high-speed Wi-Fi suitable for a professional remote work environment.
• Ability to work independently in a dedicated home office space with a closed door.

Additional Skills & Qualifications

• National pharmacy technician certifications such as PTCB or NHA.
• Experience working with Medicare and Medicaid prescription benefits.
• Background in retail pharmacy, hospital pharmacy, specialty pharmacy, PBM, or call center environments.
• Experience handling prescription benefits and prior authorization workflows in an insurance or managed care setting.
• Strong written and verbal communication skills for documenting decisions and communicating with providers and members.
• Comfort working with multiple systems and adapting to new technologies and software platforms.
• Ability to meet performance metrics and quality standards in a high-volume, process-driven environment.
• Interest in long-term career growth within a large, nationwide healthcare organization.
• Motivation to transition from contract to permanent employment, including eligibility for benefits and paid time off.

Work Environment

This is a fully remote position based in a professional home office environment, aligned with Eastern Standard Time for training and operations. Training runs from 10:00 a.m. to 6:30 p.m. EST, after which you will move to your regular shift. You must be available Monday through Friday between 8:00 a.m. and 8:00 p.m. in your local time zone and participate in a rotating weekend schedule approximately every 4-6 weeks, as well as some holidays. Holiday schedules are assigned through a bidding process. Schedules are provided approximately three months in advance, and flexibility may increase over time for individuals who meet performance metrics and demonstrate tenure. You will work on multiple monitors and within several systems simultaneously, including PBM and other pharmacy benefit platforms, while using tools such as Microsoft Office and Outlook. The organization provides core equipment, including a computer, monitor, and headset; you are expected to supply reliable high-speed Wi-Fi, a smartphone, and a dedicated workspace with a closed door to maintain privacy and focus. The environment emphasizes professionalism, accuracy, and member-focused service, with opportunities for long-term career growth and the potential to convert to a permanent role with benefits and paid time off.

Job Type & Location

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

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 12, 2026.

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.