Senior Certified Pharmacy Technician
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Job Description
Senior Certified Pharmacy Technician resolving complex pharmacy benefit and medication access issues for Gainwell Technologies’ PBM call center. Supporting members, providers, escalations, and prior authorizations remotely.
Responsibilities:
- Provide advanced support to members, prescribers, and pharmacy providers through phone, fax, email, and web-based communication channels
- Research and resolve complex pharmacy benefit inquiries, including pharmacy claims, claim rejections, formulary questions, benefit interpretation, and medication access issues
- Support and coordinate prior authorization processes
- Ensure pharmacy-related requests are handled accurately and within established guidelines
- Serve as a subject matter expert for team members
- Assist with escalated issues and share pharmacy and PBM knowledge
- Support training and onboarding activities
- Contribute to quality and process improvement initiatives
- Meet established service, productivity, compliance, and customer experience standards
Requirements:
- Active and current Certified Pharmacy Technician (CPhT) credential
- Minimum of 2 years of call center experience, preferably in a healthcare or PBM environment
- Minimum of 2 years of PBM experience, including knowledge of formulary management, pharmacy claims adjudication, and benefit interpretation
- Strong knowledge of pharmacy claims processing and claim rejection resolution
- Experience supporting or coordinating prior authorization decisions
- Strong verbal and written communication skills
- Computer proficiency
- Attention to detail
- Ability to work across multiple systems in a fast-paced, high-volume environment
- Reliable high-speed internet connection
- Private, quiet workspace suitable for handling confidential information
- Compliance with company technology, information security, and HIPAA requirements
- Successful completion of required virtual onboarding and training
- Comfort with extended computer and headset use in a call center environment
- Availability to work assigned shifts, including evenings, overnights, weekends, or holidays
- Successful completion of a skills and competency assessment
- Residence in an approved state for remote employment as defined by company policy
Benefits:
- Work flexibility
- Learning and career development
- Company-provided equipment
- Generous, flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
- Leadership and technical development academies
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