Position Summary
The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.

The Tech I will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth’s received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.

This position takes in-coming calls from members, providers, etc. providing professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions and judgment calls to the pharmacist.

Candidate should be comfortable utilizing the full MS Office Suite (MS TEAMS, Outlook are REQUIRED and Word and Excel is helpful)
At least 1 year experience as a pharmacy technician coordinating activities in an administrative support function. (preferred)
The Pharmacy Technician certification is preferred but not required at a state or national level. Will also consider a Pharm Tech Trainee license.
Advanced computer skills including word processing and spreadsheet utilization.
Excellent customer service skills (written and verbal) a must.

Duties
1. Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards.
2. Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.
3. Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc).
4. Identify and elevate clinical inquiries to the pharmacist team as appropriate.
5. Other duties assigned, for example faxes, sorting, email boxes, CAS maintenance, etc.

Experience
Minimum (1) year experience required in a customer service position with high volume call center experience; preferably in healthcare, social services, or a similar service position.
At least 6 + mos year experience as a pharmacy technician coordinating activities in an administrative support function.

Education
Verifiable High School diploma or GED is required.
Active pharmacy technician license in good standing

Top 3 Skills Required

1. High-Volume Healthcare Call Center Experience
Minimum 1 year of inbound call center experience
Healthcare, insurance, PBM, pharmacy, medical office, or similar environment preferred
Strong customer service and communication skills

2. Pharmacy Technician Experience / Knowledge
Pharmacy Technician experience strongly preferred
Active Pharmacy Technician License, Certification, or Trainee License preferred

3. Computer Multitasking & Documentation Skills
Ability to navigate multiple systems while handling calls
Proficiency with Outlook and MS Teams required
Strong data entry and documentation skills

Notes:
Fully remote
Training schedule is approximately four weeks starting 11/30/2026, Monday to Friday 8:00am - 4:30pm CST, then schedule will be assigned: Expected shifts to be 8 hours per day, Monday through Friday between 8am CST and 12am CST, with potential weekend requirements.
The work schedule will be determined after training is completed; the CW will not have a choice of shift.