Pharmacy Technician

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

📋 Description

• Act as the main point of contact for members, providers, and pharmacies through phone, chat, email, and written communication, providing prompt and accurate support across all channels.

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

• Ensure smooth interactions across phone, chat, email, and other digital platforms while upholding consistent quality and service standards.

• Assist network pharmacies with prescription claims processing, verifying claims accuracy against benefit guidelines and contractual standards.

• Support clinical pharmacists with outreach efforts to patients and providers, including appointment scheduling, enrolling members in Rightway clinical programs, and following up on medication adherence.

• Diligently document interactions and resolutions in internal systems to facilitate continuity of care, quality assurance, compliance requirements, and operational reporting.

• Take responsibility for member, provider, and pharmacy issues from the initial contact through to final resolution, collaborating with internal teams as needed to ensure timely and complete outcomes.

• Leverage AI-enabled tools and internal knowledge systems to efficiently address inquiries, document interactions, and provide a consistent member experience.

• Promote a team-oriented environment that emphasizes collaboration, respect, and diversity, while also taking on additional duties and projects as assigned.

⛳️ Requirements

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

• Certification: Must possess an active/current National Pharmacy Technician Certification (PTCB, NHA).

• Experience: 1 to 3 years of experience as a pharmacy technician in a health plan, retail pharmacy environment, TPA, or PBM contact center role. Backgrounds in mail order and specialty pharmacy are also highly desirable.

• Must have a working knowledge of pharmacy claims adjudication, benefit design, and PBM terminology.

• Detail-oriented, adaptable, and analytical, with the capability to investigate beyond symptoms to identify and resolve underlying issues.

• Empathetic and intellectually curious, with a genuine commitment to enhancing a member's healthcare experience and delivering concierge-level service across all channels.

• Comfortable multitasking and prioritizing tasks across simultaneous phone, chat, and email queues, with the independence to manage your own workload effectively.

• Able to support multiple business lines and adjust to shifting priorities based on business requirements, seasonal demands, and service levels.

🏝️ Benefits

• Health insurance

• Retirement plans

• Paid time off

• Flexible work arrangements

• Professional development

• Cybersecurity awareness training