Remote Prior Authorization Jobs in Oak Ridge, TN

Job Title: Pharmacy TechnicianJob Description The Pharmacy Technician will perform duties across various areas, including Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D/Part B, Appeals, Medicare Part D Operations, and State Health Programs Pharmacy Operations or Prior Authorization. Under established company guidelines, the Pharmacy Technician reviews requests from physicians, medical groups, pharmacies, and members concerning prescription drugs and pharmacy benefits. The technician is tasked with researching and resolving questions, problems, or issues, and may consult with Clinical Pharmacists or Regional Medical Directors when necessary. Responsibilities

• Train on Intake and Technician Review processes.
• Enter all information on the prior authorization request form into a Compass case during Intake.
• Verify intake accuracy and compare prior authorization requests and clinical documentation against appropriate criteria in Technician Review.
• Determine if requests can be approved or if additional information is needed.
• Contact the office for missing information if necessary.
• Route denials to the pharmacist queue for double-checking.
• Remediate cases requiring error correction or determination overturns.
• Manage cases in the Manual Outreach queue, communicating decisions via call or fax to providers and/or members.

Essential Skills

• Pharmacy Technician license
• 2 years of Pharmacy Technician experience
• Experience with managed care and claims
• Proficiency in data entry

Additional Skills & Qualifications

• Customer Service/retail experience preferred
• Experience with Microsoft functions such as Teams, Outlook, Word, Excel, and OneNote

Work Environment This is a fully remote role where the team stays connected through Teams via chat, audio or video call, or screen shares. Outlook is heavily utilized for team communications. The schedule during the training period (12 to 24 weeks) is Monday-Friday from 10am to 6:30pm. After training, the schedule shifts to Tuesday-Friday from 12:30pm to 9pm EST, and Saturday from 8am to 4:30pm EST. Overtime is not expected. Job Type & Location This is a Contract to Hire position based out of Knoxville, TN. 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: • 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) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Aug 4, 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. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options. San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.