Put your pharmacy expertise to work beyond the counter in a role focused on claims resolution, prior authorizations, and medication access. Join a collaborative team where your knowledge directly improves the patient experience.
Certified Pharmacy Technician (PTCB/ExCPT) – Claims & Prior Authorization
LOCATION
Fresno, CA | Onsite
COMPENSATION & SCHEDULE
- $22.00 per hour
- W2 Employment | Temporary (Potential for Conversion)
- Monday – Friday | 8-hour shift scheduled between 6:00 AM – 7:00 PM PST
- Rotating weekend coverage required
ROLE IMPACT
The Certified Pharmacy Technician plays a critical role in supporting medication access by resolving pharmacy claims, benefit verification, and prior authorization inquiries. This position partners with pharmacies, healthcare providers, and patients to deliver accurate information, resolve claim issues efficiently, and maintain compliance with HIPAA and healthcare regulations.
Success in this role is measured by claims accuracy, quality documentation, customer service, productivity, and adherence to regulatory standards.
KEY RESPONSIBILITIES
- Serve as a certified pharmacy technician supporting inbound inquiries related to pharmacy claims, benefit verification, eligibility, and prior authorizations.
- Research and resolve pharmacy claim rejections, third-party billing issues, and coverage discrepancies.
- Explain pharmacy benefit coverage, formulary requirements, and plan details clearly and professionally.
- Accurately document all customer interactions and case activity within internal systems.
- Escalate clinical questions or complex issues to licensed pharmacists or internal support teams.
- Support customer interactions through phone, email, and chat while meeting quality and productivity expectations.
- Maintain compliance with HIPAA and all applicable healthcare regulations.
MINIMUM QUALIFICATIONS
- Current Pharmacy Technician Certification through PTCB (CPhT) or NHA ExCPT
- Minimum 2 years of pharmacy technician experience in one or more of the following:
- Retail Pharmacy
- Hospital Pharmacy
- Mail Order Pharmacy
- Specialty Pharmacy
- Pharmacy Benefit Management (PBM)
- Healthcare Operations
- High School Diploma or GED.
PREFERRED QUALIFICATIONS
- Experience with prior authorizations or pharmacy claims processing.
- PBM, managed care, specialty pharmacy, or healthcare call center experience.
- Familiarity with pharmacy claims adjudication systems and third-party billing.
- Strong attention to detail with excellent documentation skills.
- Ability to manage multiple priorities in a fast-paced environment.
- Excellent customer service and communication skills.
EQUIPMENT & WORK ENVIRONMENT
- Prolonged computer use with keyboard, mouse, headset, and multi-line phone system.
- Primarily sedentary position with occasional standing, walking, reaching, and bending.
- Fast-paced healthcare support environment with productivity, quality, and compliance expectations.
LEGAL NOTICE
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