
Senior Certified Pharmacy Technician
Posted 21 hours ago

Posted 21 hours ago
This is a fully remote position, open to applicants in Texas.
• Deliver exceptional support to members, prescribers, and pharmacy providers through various communication channels including phone, fax, email, and web-based platforms.
• Investigate and resolve intricate pharmacy benefit inquiries, which encompass pharmacy claims, claim rejections, formulary questions, benefit interpretation, and medication access challenges.
• Facilitate and manage prior authorization processes efficiently.
• Ensure that pharmacy-related requests are processed accurately and in accordance with established guidelines.
• Act as a subject matter expert for team members.
• Provide assistance with escalated issues and share insights on pharmacy and PBM knowledge.
• Support training and onboarding initiatives.
• Participate in quality and process enhancement projects.
• Achieve established service, productivity, compliance, and customer experience benchmarks.
• Valid and active Certified Pharmacy Technician (CPhT) credential.
• At least 2 years of experience in a call center, ideally within a healthcare or PBM setting.
• Minimum of 2 years of experience in PBM, including familiarity with formulary management, pharmacy claims adjudication, and benefit interpretation.
• Strong understanding of pharmacy claims processing and resolution of claim rejections.
• Experience in supporting or coordinating prior authorization decisions.
• Excellent verbal and written communication abilities.
• Proficient in computer usage.
• Keen attention to detail.
• Capability to operate across multiple systems in a dynamic, high-volume environment.
• Reliable high-speed internet connection.
• A private, quiet workspace that is appropriate for managing confidential information.
• Adherence to company technology, information security, and HIPAA standards.
• Successful completion of the mandatory virtual onboarding and training.
• Comfort with prolonged computer and headset use in a call center setting.
• Availability to work designated shifts, which may include evenings, overnight hours, weekends, or holidays.
• Successful completion of a skills and competency evaluation.
• Residency in a state approved for remote work based on company policy.
• Flexible work arrangements.
• Opportunities for learning and career advancement.
• Equipment provided by the company.
• Generous and flexible vacation policy.
• 401(k) employer matching.
• Comprehensive health benefits.
• Educational support.
• Leadership and technical development academies.
TEKsystems
EVERSANA
Shields Health Solutions
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