About this role
100% Remote Pharmacy Technician Prior Authorization Review Job Description This remote Pharmacy Technician role focuses on reviewing pharmacy prior authorization requests for a large healthcare insurance organization. You evaluate coverage determinations for a wide range of health plans and medications, approve or deny requests based on established criteria, and route decisions to pharmacists for final review. The position involves extensive work in multiple computer systems, minimal phone interaction, and offers a long-term career path with the opportunity to transition to a permanent role that includes benefits and paid time off. Responsibilities
- Review pharmacy prior authorization requests for coverage determinations across multiple health plans and medication types.
- Evaluate requests against established clinical and coverage criteria to determine whether to approve or deny.
- Enter coverage determination decisions accurately into the pharmacy benefit management (PBM) system.
- Track coverage determination requests throughout the review process to ensure timely resolution.
- Obtain verbal authorizations from prescribers and request detailed clinical information when needed.
- Refer requests involving specialty medications or complex cases to appropriate clinical or specialty teams.
- Notify providers, members, and other stakeholders of coverage determination outcomes in a clear and timely manner.
- Respond to client and provider inquiries related to prior authorizations, coverage criteria, and decision status.
- Assist with inbound and outbound calls to patients or physicians as needed, primarily for information gathering or clarifications.
- Work efficiently within multiple computer systems and applications, often using several screens simultaneously.
- Maintain accurate documentation of all actions taken, information received, and decisions made in accordance with regulatory and company standards.
- Protect confidential health information and adhere to all applicable pharmacy, insurance, and privacy regulations.
- Meet productivity, accuracy, and quality metrics while working independently in a remote environment.
- Participate in training, apply new policies and procedures, and adapt to updates in systems or coverage guidelines.
Essential Skills
- Current registration as a pharmacy technician in the state of residence.
- National pharmacy technician certification (such as PTCB or NHA).
- High school diploma or GED.
- Strong computer skills, including the ability to work in multiple systems and on multiple screens simultaneously.
- Proficiency with basic computer applications, including Microsoft Office and Outlook.
- Experience with pharmacy operations and terminology, including prior authorization processes.
- Accurate and efficient data entry skills.
- Ability to review and interpret prescription and clinical information for coverage determinations.
- Customer service skills for communicating with providers, members, and internal stakeholders.
- Capability to work remotely with reliable high-speed WiFi and a dedicated workspace.
- Ability to work Monday through Friday between 8:00 a.m. and 8:00 p.m. in the local time zone, with rotating weekend and some holiday shifts.
- Comfort working in a structured, metric-driven environment and meeting performance expectations.
Additional Skills & Qualifications
- Pharmacy technician certification through PTCB or NHA.
- Registered Pharmacy Technician and Certified Pharmacy Technician credentials.
- Experience in retail pharmacy, hospital pharmacy, specialty pharmacy, or prescription benefit management (PBM) settings.
- working with Medicare and Medicaid prescription benefits.
- Prior experience in a call center or high-volume customer support environment.
- Strong attention to detail and ability to follow standardized criteria and procedures.
- Ability to manage multiple tasks and systems simultaneously while maintaining accuracy.
- Interest in a long-term career opportunity with potential to move into a permanent role.
- Motivation to earn scheduling flexibility by meeting performance metrics and demonstrating tenure.
Work Environment
This position operates in a professional remote work environment. You work from your own dedicated office space with a closed door, using multiple screens and navigating several systems throughout the day. Reliable high-speed WiFi and a smartphone are required. The organization provides essential equipment, including a computer, monitor, and headset. Training is conducted remotely on an 10:00 a.m. to 6:30 p.m. Eastern Time schedule, after which you transition to a regular shift. You must be available Monday through Friday between 8:00 a.m. and 8:00 p.m. in your local time zone, with participation in a rotating weekend schedule approximately every 46 weeks and some holiday coverage determined through a bid process. Schedules are provided three months in advance, and additional scheduling flexibility may be available based on performance metrics and tenure. The culture emphasizes professionalism, accuracy, and quality in supporting members prescription benefit needs, and offers the opportunity to grow into 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 - $24.00/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)
Job Type & Location
This is a Contract to Hire position based out of ORLANDO, FL.
Application Deadline
This position is anticipated to close on Oct 23, 2026.
Workplace Type
This is a fully remote position. 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 [email protected] 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.