Remote Pharmacy Jobs in Raleigh, NC (NOW HIRING)

Job Title: Pharmacy Technician

Job Description

This role focuses on end-to-end prior authorization and insurance support for patients receiving specialty medications. You will manage patient cases from initial intake through claim resolution, ensuring timely access to therapy by navigating insurance requirements, processing pharmacy claims, and coordinating with patients, providers, and payors. The position requires strong attention to detail, excellent communication skills, and the ability to work efficiently in a fast-paced, highly regulated environment while delivering compassionate, patient-centered service.

Responsibilities

• Recognize and clearly explain different insurance types and determine when each type should be used for patient coverage.
• Communicate with patients to collect, verify, and update insurance information needed for prior authorizations and claims processing.
• Accurately enter all communications, case updates, and documentation into the Biologics MIS and other internal systems.
• Appropriately process pharmacy claims in the Biologics MIS and interpret pharmacy claim responses to determine next steps.
• Triage prescriptions to preferred pharmacies or HUB providers when the organization is unable to serve the patient, ensuring continuity of care.
• Manage inbound calls from patients, healthcare providers, clients, and payors regarding patient updates, prior authorization status, and services provided.
• Conduct significant outbound calling to patients, clinics, and insurance providers to obtain necessary documentation, clarify requirements, and move prior authorizations forward.
• Review clinic notes and large medical records, often exceeding 90 pages, to identify and extract the documentation required by payors for prior authorization approval.
• Understand payer requirements and apply them accurately when preparing and submitting prior authorization requests.
• Work closely with platforms such as CoverMyMeds and with insurance providers to submit, track, and resolve prior authorization cases.
• Identify and report adverse events and product complaints to clinicians in accordance with established procedures.
• Manage and respond promptly to internal written communications and requests received via chat or email.
• Assist with projects such as yearly insurance reverification and other periodic operational initiatives.
• Handle a daily productivity expectation of approximately 16–20 patient cases while maintaining accuracy and quality.
• Persistently navigate patient cases, explore all available options, and resolve barriers to treatment rather than accepting initial denials.
• Support a phone-based, end-to-end prior authorization model by taking ownership of the process from start to end.
• Perform other related duties as assigned by leadership to support team goals and patient care.

Essential Skills

• Experience with prior authorization processes in a hospital, specialty pharmacy, physician office, or healthcare setting is highly preferred.
• Experience in pharmacy and insurance verification, including familiarity with pharmacy services and pharmacy claims processing.
• Ability to recognize and understand different insurance types and when each should be applied.
• Proficiency in interpreting pharmacy claim responses and determining appropriate follow-up actions.
• Experience in medical billing and coding or related insurance workflows.
• Strong ability to review clinic notes and navigate large medical records (often 90+ pages) to identify required documentation for payors.
• Comfort with significant inbound and outbound calling, including frequent interaction with patients, providers, and insurance companies.
• High level of attention to detail and accuracy in data entry, documentation, and case management.
• Strong organizational skills and the ability to manage a caseload of approximately 16–20 patients per day.
• Persistence and resourcefulness in overcoming insurance and access barriers, with a willingness to explore all available options before accepting denials.
• Ability to work independently, particularly in a hybrid/remote environment, while meeting productivity and quality expectations.
• Effective written and verbal communication skills for phone, email, and chat-based interactions.
• Comfort using case management systems such as Biologics MIS and online prior authorization platforms like CoverMyMeds.

Additional Skills & Qualifications

• Prior authorization experience in a hospital, specialty pharmacy, or healthcare setting is strongly preferred.
• Experience as a Medical Assistant is considered a strong plus.
• Pharmacy registration is a nice-to-have but not required.
• Certified Pharmacy Technician (CPhT) credential is a plus.
• Experience working in a specialty pharmacy or with rare disease therapies is beneficial.
• Ability to adapt to increased workload, such as during new drug launches or other high-volume periods.
• Comfort working within a multidisciplinary team and contributing to a collaborative, patient-focused culture.
• Demonstrated ability to thrive in a detail-oriented, time-intensive function that requires consistency and accuracy.

Work Environment

This position supports a large, rapidly growing specialty pharmacy focused on simplifying access to medication and delivering personalized care for patients, including those with rare diseases. The team operates in a hybrid model, combining office-based work with independent work from home. Tuesdays are mandatory in-office days, and the remainder of the week may be worked remotely, depending on business needs. The role follows flexible weekday shifts, such as 9:00 AM–6:00 PM, 10:00 AM–7:00 PM, and 11:00 AM–8:00 PM Eastern Time, with most hires working earlier shifts. The pharmacy operates Monday through Friday from 8:00 AM to 8:00 PM Eastern Time and is closed on weekends and major holidays. The environment is office-based and phone-focused, with no direct face-to-face patient contact. You will work closely with a multidisciplinary team using systems such as Biologics MIS and online platforms like CoverMyMeds, in a culture that emphasizes employee engagement, collaboration, and high-quality patient support.

This is a Contract to Hire position based out of Cary, NC.

The pay range for this position is $22.50 - $22.50/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)

This is a hybrid position in Cary,NC.

This position is anticipated to close on Aug 17, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

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