Job Information
Actalent REMOTE Pharmacy Technician in Oklahoma City, Oklahoma
REMOTE Pharmacy Technician
Job Description
Join our Prior Authorization Operations team to process prior authorization requests with accuracy, timeliness, productivity, and client performance commitments. Utilize various business applications for analysis, information retrieval, and data entry necessary for claims adjudication. Use reasoning skills to identify missing information and make processing determinations based on clinical protocols and client guidelines. Interact with internal and external customers to provide and obtain information and ensure outstanding service and quality. Work under general supervision with varying degrees of oversight based on demonstrated skill and performance levels.
Responsibilities
Process and finalize prior authorization (PA) requests within clients’ turnaround time (TAT) and Performance Guarantees (PGs) utilizing guidelines.
Enter prior authorizations (PAs) into the system and prioritize requests.
Check formulary alternatives, review tried and failed medications, and apply Prior Authorization Guidelines.
Utilize drug references and verify that the requested drug is indicated and approved for the condition.
Document all related information regarding the PA approval or non-approval.
Respond to incoming requests via phone, fax, ePA and return the status of the PA to physicians and pharmacies.
Conform to defined roles & responsibilities and rules of engagement between prior authorization processing and clinical decision making.
Partner with assigned clinical pharmacists to ensure strict adherence to the boundaries and timeframes of administrative processing.
Achieve prior authorization processing productivity and accuracy standards.
Analyze, research, and resolve prior authorization processing issues, including making written or telephone inquiries to obtain information from clients, members, physicians, or pharmacies.
Coordinate notifications to members, physicians, and pharmacies to obtain missing information, manage pended requests, and communicate prior authorization determinations.
Collaborate with MCO and Self-Insured client teams to understand PBM clients’ prior authorization processing requirements and expectations.
Partner with client teams to complete special prior authorization processing projects and provide accurate, timely, and reliable information to client claim inquiries.
Collaborate with Contact Center Services in resolving prior authorization inquiries and handling incoming calls during periods of high volume.
Protect and maintain confidentiality and privacy of all prior authorization and member information.
Essential Skills
Active pharm tech license in state of residence.
Minimum of 3 years of pharmacy technician experience.
PTCB (CPhT) certification without restrictions OR State Pharmacy Technician license of the state they currently reside in.
Understanding of managed pharmacy benefit concepts including formulas, prior authorizations, edits, and claim adjudication.
Working knowledge of customer service in a retail/outpatient pharmacy environment.
Familiarity with pharmacy software data submission requirements such as CovermyMeds or Electronic Prior Authorization (e-PA).
Additional Skills & Qualifications
Intermediate knowledge of MS Office/Word, Excel, and Outlook.
Aptitude for new programs and experience with Windows-based database programs.
Ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals, and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment.
Work Environment
Remote work environment requiring a quiet workspace and a high-speed internet connection.
Shifts available: 5:00 AM - 1:30 PM, 7:30 AM - 4:00 PM, 9:30 AM - 6:00 PM, 11:00 AM - 7:30 PM, 2:30 PM - 11:00 PM.
Benefits include medical, dental, vision, wellness programs, paid time off, company-paid holidays, incentive compensation, 401K with company match, life and disability insurance, tuition reimbursement, and employee referral bonus.
Pay and Benefits
The pay range for this position is $23.50
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 Mar 26, 2025.
Pay and Benefits
The pay range for this position is $17.00 - $24.59/hr.
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 onsite position in Oklahoma City,OK.
Application Deadline
This position is anticipated to close on Mar 27, 2025.
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 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
Hiring diverse talent
Maintaining an inclusive environment through persistent self-reflection
Building a culture of care, engagement, and recognition with clear outcomes
Ensuring growth opportunities for our people
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 (%20actalentaccommodation@actalentservices.com) for other accommodation options.