Certified Pharmacy Technician
4 days ago
Las Vegas
Job Description Job Description Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. Responsibilities • Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists., • Researches, resolves and documents prior authorization outcomes in pharmacy system., • Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists., • Escalates requests to Pharmacist when request requires extensive clinical review or denial., • Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management. Performs other duties as required. For CPTs assigned to work the fax queue, responsibilities will also include: • Clinically reviews coverage determinations with attention to detail, for medications via Fax., • Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists within SLA (service level agreement) guidelines., • Efficiently multi-tasks and monitors several queues and assignments. Adapts to team requirements as business needs change (e.g., fax work, pending queues, oral notifications, and failed faxes). Minimum Qualifications • High school diploma from an accredited school or equivalent GED, • Required CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, • Required Pharmacy Experience, 0-2 years, • Must be eligible to work in the United States without the need for work visa or residency sponsorship Additional Qualifications • Must have an active pharmacy technician licensure or registration in accordance with state requirements., • If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT), • In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT)., • Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting., • In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.)., • Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite., • Excellent written and verbal communication skills., • Ability to follow clinical criteria and instructions to approve prior authorization requests., • Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted., • Ability to identify and trouble-shoot problematic issues. Preferred Qualifications • Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures, • Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.Company DescriptionC4 Technical Services is a forward-thinking IT, Telecom and Clinical consulting and talent solutions firm headquartered in Eagan, Minnesota, with additional offices in Sacramento, CA, Dallas, TX, and Hyderabad, India. We serve clients across industries by delivering tailored technology solutions and connecting them with top-tier IT talent. At C4, we combine deep technical expertise with a commitment to flexibility, cost-efficiency, and long-term impact. Our services are built to scale with your business and evolve alongside your needs. We support contract, contract-to-hire, and permanent placement models — allowing you to build the right team, at the right time, with the right expertise. Learn more about how we can support your technology and staffing needs at Or reach out to us directly at Technical Services is a forward-thinking IT, Telecom and Clinical consulting and talent solutions firm headquartered in Eagan, Minnesota, with additional offices in Sacramento, CA, Dallas, TX, and Hyderabad, India. \r\n\r\nWe serve clients across industries by delivering tailored technology solutions and connecting them with top-tier IT talent.\r\n\r\nAt C4, we combine deep technical expertise with a commitment to flexibility, cost-efficiency, and long-term impact. \r\n\r\nOur services are built to scale with your business and evolve alongside your needs.\r\n\r\nWe support contract, contract-to-hire, and permanent placement models — allowing you to build the right team, at the right time, with the right expertise.\r\n\r\n\r\n Learn more about how we can support your technology and staffing needs at\r\n Or reach out to us directly at