Job Title

Job Title: Pharmacy Technician u2013 Appeals DepartmentJob Description This role offers an opportunity for a licensed Pharmacy Technician to support the appeals process for Medicare and Medicaid members, with a primary focus on Medicare. You will review denied prior authorization requests, gather additional clinical or administrative information as needed, and prepare complete case files for pharmacists to make final coverage determinations. The position centers on outbound phone-based customer service with members who may be frustrated about medication denials, requiring strong communication skills, empathy, and the ability to manage conversations effectively while maintaining accuracy in documentation and data entry. Responsibilities + Review denied prior authorization cases for Medicare and Medicaid members, with a primary focus on Medicare appeals. + Evaluate information provided in each case to determine what additional details are needed to support the appeal. + Make 30u201360 outbound calls per shift to members and other relevant parties to obtain missing or clarifying information. + Communicate clearly and empathetically with Medicare and elderly members who may be frustrated about medication denials. + Ask targeted questions and control the conversation to keep calls focused and productive while maintaining a professional and supportive tone. + Gather and document clinical and administrative details related to medications, including injectable therapies administered in a doctoru2019s office. + Accurately enter and update case information in the appropriate systems and databases. + Prepare complete and organized case files and forward them to pharmacists for final determination on whether to uphold or overturn denials. + Follow established appeals procedures, guidelines, and timelines to ensure efficient and compliant case handling. + Collaborate with pharmacists and other team members as needed to clarify case details and support timely decision-making. Essential Skills + Active pharmacy technician license. + Experience working in a pharmacy or managed care environment. + Knowledge of pharmacy operations, medication terminology, and prior authorization processes. + Familiarity with appeals, managed care, claims, and denial workflows. + Strong customer service skills over the phone, including the ability to handle difficult or emotional conversations. + Ability to control and guide conversations and redirect discussions when necessary. + Proficiency in accurate and efficient data entry. + Strong attention to detail and ability to review and interpret case information. + Clear verbal communication skills and professional telephone etiquette. Additional Skills & Qualifications + Experience working with Medicare and Medicaid populations. + Background in handling medication-related inquiries, particularly for injectable medications administered in clinical settings. + Comfort working in a structured, process-driven appeals environment. + Ability to multitask between phone calls, documentation, and case review activities. + Strong organizational skills and ability to manage a steady volume of outbound calls. Work Environment This position operates in a professional, office-based or remote call-center environment focused on pharmacy appeals. You will spend the majority of your time on the phone making outbound calls to members and documenting information in computer-based systems. The work follows structured procedures and timelines, with a consistent daily volume of 30u201360 outbound calls. The environment emphasizes accuracy, confidentiality, and respectful communication with Medicare and Medicaid members, many of whom may be elderly and experiencing frustration about medication denials. Standard professional attire is expected in on-site settings, and a quiet, distraction-free workspace is required for remote work. Job Type & Location This is a Contract to Hire position based out of Columbus, OH. 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: u2022 Medical, dental & vision u2022 Critical Illness, Accident, and Hospital u2022 401(k) Retirement Plan u2013 Pre-tax and Roth post-tax contributions available u2022 Life Insurance (Voluntary Life & AD&D for the employee and dependents) u2022 Short and long-term disability u2022 Health Spending Account (HSA) u2022 Transportation benefits u2022 Employee Assistance Program u2022 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 6, 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, weu2019ve helped visionary companies advance their goals. Headquartered in the United States, our teams span 150 offices across North America, EMEA, and APACu2014with 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 .