Prior Authorization Pharmacy Technician (Seasonal)

Job Summary:

• This is a 6-month contract position assisting members, providers, and internal teams with prescription coverage and prior authorization.
• Involves coordinating clinical review cases, checking coverage, and troubleshooting escalations.

What you will do:

• Verify eligibility and drug coverage under plan benefit design for appropriate claims processing.
• Review prior authorization requests using criteria, claims history, and plan rules.
• Build and adjust authorizations within the claim adjudication system and evaluate clinical situations for approvals.

What you will bring to SmithRx:

• Active Pharmacy Technician license and 2-4 years of experience as a Pharmacy Technician.
• 2+ years of prior authorization review experience at a PBM or health plan.
• Proficiency in Mac, MS Office, G-Suite, and strong critical thinking and communication skills.