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Pharmacy Claims Remote Jobs (NOW HIRING)

Actalent

Pharmacy Technician

Cary, NC · Remote

$17.25 - $21/hr

Appropriately process pharmacy claims in the Biologics MIS and interpret pharmacy claim responses ... Ability to work independently, particularly in a hybrid/remote environment, while meeting ...

Sentara Healthcare

Pharmacy IT Solutions Manager

Norfolk, VA · On-site +1

$63 - $74/hr

The manager functions as a subject matter expert for pharmacy systems, pharmacy claims data ... For positions that are available as remote work, Sentara Health employs associates in the following ...

Amwins

Amwins A&H- Claims Manager, Stop Loss

Seattle, WA · Remote

Manager, Stop Loss Claims (Remote) Amwins Accident & Health Underwriters, formerly known as Beacon ... Stay abreast of industry changes as related to emerging medical and pharmacy trends as well as cost ...

Amwins

Amwins A&H- Claims Manager, Stop Loss

Seattle, WA · Remote

Manager, Stop Loss Claims (Remote) Amwins Accident & Health Underwriters, formerly known as Beacon ... Stay abreast of industry changes as related to emerging medical and pharmacy trends as well as cost ...

1 point system

Data Engineer

Rock Hill, SC · Remote

$117K - $140K/yr

... Remote Contract W2 Assessment test required Assessment required - PL/SQL, Data Analysis, NoSQL (MongoDB, Cassandra, Nejo4J) ** Healthcare experience ** Medical & Pharmacy Claims experience ...

CorVel Enterprise Claims, Inc.

Claims Assistant

Franklin, TN · Remote

$13.38 - $23.42/hr

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Sets up new claims * Process mail ... Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account ...

New

Pacer Group

Clinical - Clinical Pharmacist 1

$121K - $144K/yr

Clinical Pharmacist I We are hiring a Clinical Pharmacist I to join a remote Pharmacy Appeals team ... Evaluate clinical information, medical records, and pharmacy claims. * Review pharmacy technician ...

New

Bestica Healthcare

Pharmacy - Pharmacist Inpatient

$59.50 - $71.75/hr

Non-Billable Orientation (NBO) Job - Remote Managed Care Pharmacist Pharmacist License Required for ... The CPS is skilled at reviewing pharmacy and medical claims; interacting with, assessing and ...

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Pharmacy Claims Remote information

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How much do pharmacy claims remote jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for pharmacy claims remote in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 per hour, depending on experience, location, and employer.

How does a pharmacy claims remote professional typically collaborate with other team members when working from home?

Pharmacy Claims Remote professionals frequently interact with pharmacists, insurance representatives, and other claims specialists using virtual communication tools like email, chat, and video conferencing. While most tasks are individually completed, such as reviewing and processing claims, there are regular team meetings to discuss complex cases or policy updates. Clear communication and timely responses are essential to ensure claims are handled efficiently and in compliance with regulations. The remote setting requires proactive engagement with team members to address any issues and maintain workflow continuity.

What skills and qualifications are needed to thrive as a pharmacy claims remote specialist?

To thrive as a Pharmacy Claims Remote Specialist, you need strong attention to detail, knowledge of pharmacy operations, and familiarity with insurance claim processes, often supported by a pharmacy technician certification or relevant experience. Proficiency with pharmacy benefit management (PBM) systems, claims processing software, and electronic health record (EHR) platforms is typically required. Excellent communication, problem-solving, and organizational skills help you efficiently resolve claim issues and support customers remotely. These skills ensure accurate claims processing, regulatory compliance, and high-quality service for patients and providers.

What is a pharmacy claims remote job?

Pharmacy claims remote jobs involve processing and reviewing prescription drug claims for insurance companies, pharmacy benefit managers, or healthcare organizations from a remote location. These roles typically require knowledge of pharmacy billing, insurance procedures, and healthcare regulations. Employees in these positions may verify coverage, resolve claim discrepancies, and communicate with pharmacies, patients, or insurance providers. Strong attention to detail and computer skills are important, and some positions may require pharmacy technician certification or prior experience in claims processing.
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What cities are hiring for Pharmacy Claims Remote jobs? Cities with the most Pharmacy Claims Remote job openings:
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Pharmacy Claims Remote jobs near you
Infographic showing various Pharmacy Claims Remote job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 69% Full Time, 27% Part Time, and 3% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Pharmacy Tech, Prior Auth CPhT or PTCB (Remote)

Molina Healthcare

Remote

$12.19 - $26.42/hr

Full-time

Posted 25 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 198 frontline employees who took The Breakroom Quiz

164th of 303 rated insurance

Job description


Molina Healthcare is hiring for a Pharmacy Technician who is State Licensed/Certified and/or PTCB certified.
This role is 100% remote, and the hours will be Mon-Fri 10am to 630pm Pacific Standard Time.
This role will be reviewing prior authorization requests for medications to be reviewed by the RPh's and or MD's for determination, assisting in determining medical necessity for medications along with assisting with pharmacy claims.
Highly qualified candidates for this role will have the following experience-
  • 2+ years in a retail setting
  • Prior Authorization experience
  • Must be computer savvy- able to work within several computer systems at once
  • Managed care experience
  • High level of communication skills, both written and verbal

Essential Job Duties
  • Provides support for pharmacy technician activities. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care.
  • Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests.
  • Accurately enters approvals or denials of requests.
  • Facilitates prior authorization requests within established pharmacy policies and procedures.
  • Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices.
  • Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership.
  • Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues.
  • Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed

Required Qualifications
  • At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience.
  • Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice.
  • Ability to abide by Molina policies.
  • Ability to maintain attendance to support required quality and quantity of work.
  • Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
  • Excellent verbal and written communication skills.
  • Microsoft Office suite (including Excel), and applicable software program(s) proficiency.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Key Words: Pharmacy Technician, Pharm Tech, Tech, National Certification, State License, Certification, Claims, Pharmacy Claims, Pharmacy, PBM, National Certified Pharmacy Technician (CPhT) certification, Medicaid, Medicare, Managed Care, MCO, Exchange, PBM, Pharmacy Benefit Management, Prior Auth

What Molina Healthcare employees say

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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