Prior Authorization Representative

Job Title: Prior Authorization Technician Location: Fully Remote (Work from Home - Anywhere in the U.S.) Pay Rate: $17.90/hour (W2) Schedule: Monday–Friday, 8-hour shifts between 8:00 AM–8:00 PM CT Training Schedule: Monday–Friday, 8:00 AM–4:30 PM CT Position Summary: Seeking Pharmacy Technicians I with prior experience in high-volume call centers and customer service, preferably within the healthcare or social services sector. In this role, you will handle inbound calls from members, providers, and other stakeholders, providing professional and efficient support through the criteria-based prior authorization process. You will document all approvals and denials and escalate clinical questions or judgment calls to the pharmacist. Key Responsibilities: • Answer inbound calls regarding pharmacy benefit inquiries and prior authorizations. • Guide callers through the criteria-based prior authorization process. • Maintain detailed, accurate, and timely documentation of all interactions. • Escalate clinical or judgment-based issues to licensed pharmacists. • Deliver excellent customer service while working in a fast-paced environment. Required Qualifications: • Minimum 1 year of experience in a customer service or high-volume call center role. • High School Diploma or GED (must be verifiable). • Advanced computer proficiency including word processing and spreadsheet tools. • Strong communication skills – verbal and written. • Ability to work independently in a quiet, dedicated home workspace. • Must meet minimum internet speed requirements: 25 Mbps download / 3 Mbps upload (wired connection preferred). Apply tot his job