Pharmacy Technician

This is a fully remote position, open to applicants in Florida.

📋 Description

• Act as the main point of contact for members, providers, and pharmacies through phone, chat, email, and written communication.

• Address inquiries related to mail order, benefit design, formulary coverage, medication costs, prior authorization criteria, and claims processing.

• Facilitate interactions via phone, chat, email, and other digital platforms while upholding quality and service standards.

• Assist network pharmacies in managing prescription claims and evaluate claims against benefit guidelines and contract standards.

• Aid clinical pharmacists with outreach to patients and providers, scheduling appointments, enrolling in clinical programs, and following up on medication adherence.

• Record interactions and resolutions in internal systems to ensure continuity of care, quality assurance, compliance, and operational reporting.

• Take ownership of member, provider, and pharmacy issues until resolution, coordinating with internal teams as necessary.

• Utilize AI-enabled tools and internal knowledge bases to resolve inquiries and document interactions.

• Promote a collaborative, respectful, and diverse team environment while undertaking assigned duties and projects.

⛳️ Requirements

• Active/Current National Pharmacy Technician Certification (PTCB, NHA).

• 1 to 3 years of experience as a pharmacy technician in a health plan, retail pharmacy setting, TPA, or PBM contact center role.

• Experience in mail order and specialty pharmacy is highly desirable.

• Familiarity with pharmacy claims processing, benefit design, and PBM terminology.

• An associate's or bachelor's degree is preferred, or equivalent relevant work experience.

• Detail-oriented, adaptable, and analytical, with a strong ability for root cause problem-solving.

• Empathetic and intellectually curious, with a commitment to enhancing members' healthcare experiences.

• Capacity to multitask and prioritize concurrent phone, chat, and email inquiries.

• Ability to independently manage workload.

• Capability to support multiple lines of business and adapt to shifting priorities.

🏝️ Benefits

• Remote work arrangement.

• Equal Opportunity Employer with an inclusive culture.

• Access to AI-enabled tools and internal knowledge systems.