Call Center Pharmacy Technician - Remote MS

About the position It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. SummaryThe Call Center Pharmacy Technician supports the PBM clinical and technical call center by serving as a subject matter expert in pharmacy operations and call center processes. In this role, you will assist members, medical providers, and pharmacy providers by processing prior authorizations, resolving pharmacy claims inquiries, and ensuring timely and accurate communication across multiple platforms. This position plays a critical role in supporting regulatory compliance, service level agreements, and high-quality customer care.Your role in our mission Process prior authorization requests within state-mandated turnaround times, including approval of requests that meet established criteria and do not require pharmacist review. Answer inbound and make outbound calls to members, medical providers, and pharmacy providers to resolve inquiries related to pharmacy claims, drug coverage, and plan benefits. Document all inquiries and interactions accurately across phone, fax, web, and email platforms in accordance with standard operating procedures. Maintain strict compliance with PHI regulations, data privacy standards, and all internal security policies. Meet departmental productivity goals, quality standards, and performance expectations while identifying opportunities for process improvement. What we're looking for Active pharmacy technician registration with the Mississippi Board of Pharmacy and current national certification (PTCB, ExCPT, or equivalent). Minimum of two (2) years of pharmacy technician experience in retail pharmacy, hospital pharmacy, managed care, insurance, or PBM environment. Strong working knowledge of pharmacy point-of-sale claims, prior authorization processes, and medication terminology. Proficiency in Microsoft Office applications and ability to navigate multiple computer systems simultaneously. Excellent communication skills with the ability to provide clear, professional support to members and providers. What you should expect in this role Remote position limited to current residents of Mississippi, supporting a state Medicaid/PBM program in a high-volume clinical and technical call center environment. Performance-driven culture with defined productivity, quality, regulatory, and service level expectations. Ongoing training to support compliance with state requirements, pharmacy guidelines, and evolving client standards. Reliable high-speed internet connection required, with minimum download speed of 25 Mbps and upload speed of 10 Mbps, and a private workspace suitable for handling confidential PHI. Access to Gainwell’s comprehensive benefits package in accordance with eligibility guidelines, including medical, dental, vision, and 401(k) options. #LI-REMOTE #LI-JT1 The pay range for this position is $32,700.00 - $46,700.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

Responsibilities

• Process prior authorization requests within state-mandated turnaround times, including approval of requests that meet established criteria and do not require pharmacist review.
• Answer inbound and make outbound calls to members, medical providers, and pharmacy providers to resolve inquiries related to pharmacy claims, drug coverage, and plan benefits.
• Document all inquiries and interactions accurately across phone, fax, web, and email platforms in accordance with standard operating procedures.
• Maintain strict compliance with PHI regulations, data privacy standards, and all internal security policies.
• Meet departmental productivity goals, quality standards, and performance expectations while identifying opportunities for process improvement.

Requirements

• Active pharmacy technician registration with the Mississippi Board of Pharmacy and current national certification (PTCB, ExCPT, or equivalent).
• Minimum of two (2) years of pharmacy technician experience in retail pharmacy, hospital pharmacy, managed care, insurance, or PBM environment.
• Strong working knowledge of pharmacy point-of-sale claims, prior authorization processes, and medication terminology.
• Proficiency in Microsoft Office applications and ability to navigate multiple computer systems simultaneously.
• Excellent communication skills with the ability to provide clear, professional support to members and providers.
• Reliable high-speed internet connection required, with minimum download speed of 25 Mbps and upload speed of 10 Mbps, and a private workspace suitable for handling confidential PHI.

Benefits

• medical
• dental
• vision
• 401(k) options
• flexible vacation policy
• 401(k) employer match
• comprehensive health benefits
• educational assistance

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