Pharmacy Technician, Prior Authorization

Location: Remote USA; working hours are 11:30 AM–8 PM EST with a mandatory weekend rotation.

Salary: $20.90–$26.25 per year.

Company

hirify.global operates an integrated care platform focused on improving the health and well-being of older Americans through clinical and service experiences.

What you will do

• Review and determine prior authorization requests using company policies and decision trees.
• Triage and enter requests from provider offices and obtain required clinical documentation from hospitals and healthcare providers.
• Apply preferred product strategies and support utilization management for the Medicare Part B medication benefit.
• Communicate clinical decisions and alternative treatment options to provider groups and members.
• Interpret plan benefits and enter specialty pharmacy overrides for accurate claim adjudication.
• Coordinate workflows as a primary contact for internal and external stakeholders and support offshore clinical partners.

Requirements

• Nationally Certified Pharmacy Technician (CPhT) certification with at least three years of experience.
• Experience with Medicare Part B operations, including pharmacy help desk, utilization management, or prior authorizations.
• Experience caring for Medicare patients and a strong interest in supporting aging populations.
• Proficiency with technology, including Gmail and G Suite.
• Strong organization, attention to detail, communication, multitasking, and problem-solving skills.

Nice to have

• Prior experience in utilization management.
• Experience improving operational processes in a fast-paced environment.

Culture & Benefits

• Fast-paced environment with changing priorities and a focus on accountability and collaboration.
• Employer-sponsored health, dental, and vision plans with low or no premiums.
• Generous paid time off and a parental leave program.
• $100 monthly mobile or internet stipend.
• Stock options for all employees and a 401(k) program.