Pharmacy Technician

The Pharmacy Technician in the Appeals department supports Medicare and Medicaid members by reviewing denied prior authorizations and facilitating fair, accurate appeal decisions. You will work primarily with Medicare patients, carefully review clinical and claim information, obtain any missing details, and prepare complete cases for pharmacists to make final determinations on whether to uphold or overturn denials. This role combines pharmacy knowledge, managed care processes, and empathetic phone-based customer service to help members access the medications they need. Responsibilities Review denied prior authorization requests for Medicare and Medicaid members, with a primary focus on Medicare cases. Analyze appeal cases for completeness and accuracy, ensuring all relevant clinical and claim information is included. Reach out to members, providers, or other stakeholders to obtain additional information needed to process appeals. Prepare and organize case files and documentation for pharmacists to make final determinations on whether to maintain or overturn denials. Handle a high volume of outbound calls each shift, typically 30-60 calls, to Medicare and elderly members regarding their denied medications. Explain the appeals process clearly and calmly to members who may be frustrated or upset about medication denials. Control and guide conversations professionally, redirecting discussions as needed to gather necessary information and maintain focus on resolving the issue. Perform accurate and timely data entry of appeal and claims information into relevant systems. Collaborate with pharmacists and other internal team members to ensure efficient and compliant processing of appeals. Maintain confidentiality and handle sensitive health and medication information in accordance with applicable regulations and internal policies. Essential Skills Active pharmacy technician license. Experience working in a pharmacy or managed care setting. Strong data entry skills with high attention to detail and accuracy. Proven ability to provide customer service over the phone. Ability to handle challenging calls with empathy, patience, and professionalism. Skill in controlling conversations and redirecting discussions when necessary to obtain required information. Clear, professional verbal communication skills, especially with Medicare and elderly members. Work Environment This role operates in a professional, office-style or remote call center environment focused on processing pharmacy appeals for Medicare and Medicaid members. You will spend most of your time on the phone making outbound calls and working at a computer to review cases and enter data into internal systems. The position requires consistent, focused work with a steady volume of 30-60 outbound calls per shift and careful attention to documentation. The environment emphasizes accuracy, confidentiality, and compassionate communication with members who may be frustrated about denied medications. 6 week training schedule: Monday to Friday, 10 AM to 6:30 PM EST.

After training schedule:

Monday - Friday 10AM-6:30PM Lunch breaks range from 30 minutes to an hour. Holiday coverage is rotated among team members once fully trained. Job Type & Location This is a Contract to Hire position based out of Clay City, KY. Pay and Benefits The pay range for this position is $18.00 - $20.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position.

Application Deadline This position is anticipated to close on May 8, 2026. Diversity, Equity & Inclusion At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I is embedded into our culture through: Hiring diverse talent Maintaining an inclusive environment through persistent self-reflection Building a culture of care, engagement, and recognition with clear outcomes Ensuring growth opportunities for our people Actalent is an equal opportunity employer. About Actalent Actalent is a global leader in engineering and sciences services. For more than 40 years, we've helped visionary companies advance their goals. Headquartered in the United States, our teams span 150 offices across North America, EMEA, and APAC—with four delivery centers in India led by 1,000+ extraordinary employees who connect their passion with purpose every day. Our Bangalore, Hyderabad, Pune, and Chennai delivery centers are hubs of engineering expertise, with core capabilities in mechanical and electrical engineering, systems and software, and manufacturing engineering. Our teams deliver work across multiple industries including transportation, consumer and industrial products, and life sciences. We serve more than 4,500 clients, including many Fortune 500 brands. Learn more about how we can work together at actalentservices.com.