Pharmacy Technician – Prescription Routing & Claims Support

PHIL is looking for a full-time Pharmacy Technician

Monday through Friday shifts.

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  Troubleshooting electronic, faxed, and verbal prescriptions via routing to appropriate channels into pharmacy systems

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  Review and update patient insurance using payer portals and phone resources

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  Determining appropriate situations for a prior authorization (PAs) need via payer-specific tools; troubleshoot denials and escalations

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  Utilize reroute best practices for orders falling outside normal workflow, including orders with state changes, insurance exceptions, pharmacy rejections, or failed transfers

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  Navigate operational platforms (e.g., BestRx, Ops Dash, Partner Dash, RelayHealth, etc.) and vendor systems effectively

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  Follow reroute protocols for specific tags including: non-contracted pharmacies, state shipping changes, PP send-backs, transfer not received, and more

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  Proactively document process notes with clear routing details, claim updates, and actions taken

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  Communicate with partner pharmacies, provider offices, and insurance carriers to resolve issues or clarify documentation

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  Collaborate with At-Risk, Partner Management, and PPM teams to escalate or flag orders based on system outages, stock issues, or policy refusals

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  Maintain productivity in the Reroute queue even during extended call hold times (e.g., multitask during insurance calls)

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  Ensure all patient, prescriber, and partner communications are clear, professional, and aligned with Phil’s standards of care

• You thrive in a fast-paced, evolving startup environment and remain composed under pressure

• You're passionate about helping patients access necessary medications

• You are tech-savvy, comfortable toggling between multiple software systems and navigating insurance workflows

• You’re a strong communicator, able to write succinct internal notes and speak clearly with external stakeholders

• You’re self-driven but collaborative; you seek clarity, ask smart questions, and take initiative

• You take pride in accuracy and process adherence, especially when rerouting orders or resolving insurance mismatches

• Pharmacy Technician License in the state of residence(required)

• PTCB certification (preferred)

• Minimum 1 year of pharmacy technician experience, preferably in a Specialty, Mail Order, PBM (with Manufacturer and Insurance troubleshooting experience) or Retail setting.
  

• Insurance claim rejections (e.g., Reject 50/40, DUR codes, etc.)

• Prior authorizations, override codes, and split billing scenarios

• ICD-10 codes and drug classifications

• FSA/HSA card restrictions and processing nuances

• Medicaid/Medicare Experience

• Routing tools and reroute resolution logic

• Ability to work efficiently and with attention to detail, especially when handling complex re-routes

• Strong written documentation and case management skills