Certified Pharmacy Technician I
*Must be a licensed SA Certified Pharmacy Technician
*This is a 1-year contract position – conversion possible
*Remote – must reside in Virginia only
*Monday–Friday, 9 AM–8 PM EST; overtime required as needed
Overview:
The SA Certified Pharmacy Technician will evaluate and authorize prior authorization (PA) pharmacy requests received via phone and fax in a call center environment. This role applies client clinical criteria, communicates decisions to healthcare providers, and ensures accurate documentation within established service levels.
Responsibilities:
- Handle inbound and/or outbound patient and physician calls.
- Research and resolve rejected insurance billing issues and escalated member concerns.
- Determine medication appropriateness based on clinical criteria and communicate decisions to physicians, office staff, medical management, and pharmacists.
- Document prior authorization outcomes in the pharmacy system.
- Communicate PA criteria, pharmacy benefit coverage, and formulary alternatives to providers and internal teams.
- Escalate requests requiring extensive clinical review or denial to a Pharmacist.
- Resolve physician or client inquiries and grievances; provide verbal or written responses to clients, prescribers, providers, and management.
- Efficiently multitask across multiple queues and adapt to operational needs (fax work, pending queues, oral notifications, failed faxes, etc.).
- Clinically review coverage determinations for medications received via fax with strong attention to detail.
- Communicate decisions to healthcare providers within SLA guidelines.
- Perform other duties as assigned.
Required Skills & Qualifications:
- High School Diploma required.
- 0–2 years of Pharmacy Technician experience.
- Basic computer skills.
- SA Certified Pharmacy Technician certification preferred/required per contract needs.
Attention Applicants: Please be advised that proper email communication will only be sent from email addresses ending in @astyra.com. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. It is important to communicate within our guidelines and proper channels to expedite possible interview considerations.
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