Pharmacy Technician, Care Team
R
RightwayPharmacy Benefits
Location: RemoteFull-TimeMiddle
Salary21.5 - 22 USD per hour
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Job Details
- Experience
- 1 to 3 years
Requirements
- Active/Current National Pharmacy Technician Certification (PTCB, NHA).
- 1 to 3 years of experience as a pharmacy technician in a health plan, retail pharmacy setting, TPA, or PBM contact center role.
- Working knowledge of pharmacy claims adjudication, benefit design, and PBM terminology.
- Associate's or bachelor's degree preferred, or equivalent relevant work experience.
- Ability to multitask and prioritize across concurrent phone, chat, and email queues.
- Strong analytical skills with the ability to identify and resolve root causes.
- Empathetic approach with a commitment to delivering concierge-level service.
- Comfortable supporting multiple lines of business and shifting priorities.
Responsibilities
- Serve as the primary point of contact for members, providers, and pharmacies across phone, chat, email, and written correspondence.
- Field and resolve inquiries related to mail order, benefit design, formulary coverage, medication cost, prior authorization criteria, and claims adjudication.
- Support clinical pharmacists with patient and provider outreach, including scheduling appointments, enrolling members in clinical programs, and following up on medication adherence.
- Assist network pharmacies in processing prescription claims, reviewing claims for accuracy against benefit guidelines and contract standards.
- Accurately document interactions and resolutions within internal systems to support continuity of care, quality assurance, and compliance.
- Take ownership of member, provider, and pharmacy issues from initial contact through final resolution.
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