As a Pharmacy Technician in the Appeals department, you will primarily handle cases involving denied Prior Authorizations for Medicare and Medicaid patients. Your main responsibilities include reviewing cases, reaching out for necessary additional information, and preparing cases for Pharmacists who will make the final determination on whether to uphold or overturn the denial. This role involves making about 60 outbound calls per shift to elderly members, addressing their concerns about denied medication, predominantly injectables administered at a doctor's office. You will be expected to work independently in a remote setting, ensuring a distraction-free, HIPAA-compliant environment.
Hard Skills
Pharmacy Technician experience
Customer service
Computer skills
Ability to work remotely
Soft Skills
Independent working
Strong communication
Problem-solving
Empathy
Work Site
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 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
Hiring diverse talent
Maintaining an inclusive environment through persistent self-reflection
Building a culture of care, engagement, and recognition with clear outcomes
Ensuring growth opportunities for our people
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 actalentaccommodation@actalentservices.com for other accommodation options.
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Business Consulting and Services
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