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
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.
• 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.
Benefits
• Access to Gainwell’s comprehensive benefits package in accordance with eligibility guidelines, including medical, dental, vision, and 401(k) options.
• flexible vacation policy
• 401(k) employer match
• comprehensive health benefits
• educational assistance
• leadership and technical development academies
Apply tot his job
Apply To this Job
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
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.
• 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.
Benefits
• Access to Gainwell’s comprehensive benefits package in accordance with eligibility guidelines, including medical, dental, vision, and 401(k) options.
• flexible vacation policy
• 401(k) employer match
• comprehensive health benefits
• educational assistance
• leadership and technical development academies
Apply tot his job
Apply To this Job