FairosRx Clinical Associate (On-Site or Remote) - Pharmacy Technician Certification Required

The OccuNet Company•Amarillo, TX

13d•Hybrid

About The Position

The OccuNet Company is an innovative company striving to reduce the cost of healthcare. We are a passionate group of people that care about affordable access to healthcare without sacrificing experience. We strive to make healthcare more intelligent, streamlined, and cost-effective. We offer industry-leading capabilities on negotiations-driven levers to contain rising healthcare costs while taking an experience-centric approach improving the health and well-being of those we serve. We pride ourselves on our tight knit culture based on the ‘outward mindset’ philosophy, emphasizing empathy, mutual respect, and seeing each other as “whole people.” We have an ambitious vision and are growing quickly. We are seeking team members who are excited about our growth, seeking to thrive in a fast-paced environment, and enthusiastic about developing their skills and career alongside us. As a Clinical Associate, you will support pharmacy benefit operations by coordinating clinical and administrative workflows, reviewing documentation, and communicating with members, providers, pharmacy staff, clients, and internal stakeholders. The role helps ensure accurate, timely, and compliant processing of pharmacy benefit requests while supporting service quality and operational efficiency.

Requirements

Excellent communication and interpersonal skills, written and verbal, with the ability to adapt appropriately for different audiences.
Able to multi-task effectively and transition between tasks frequently and maintain focus when presented with interruptions.
Proficient computer skills, including Microsoft Office Suite.
Team-first mindset with a high level of motivation and drive.
High school diploma or equivalent.
Active certified pharmacy technician (CPhT)
Prolonged periods sitting or standing at a desk and working on a computer.

Nice To Haves

PBM experience preferred.
A track record of fostering collaboration, resolving conflicts and managing projects preferred.

Responsibilities

Collect, verify, and document clinical information from providers, pharmacies, and members.
Assist pharmacists with utilization management, coverage determinations, and appeals processing.
Monitor work queues and meet productivity, quality, and turnaround time expectations.
Process pharmacy claims and resolve claim adjudication issues.
Research member eligibility, benefit coverage, and medication history.
Communicate with prescribers, pharmacies, and members regarding authorization status, coverage requirements, and alternative therapies.
Provide customer service and respond to inquiries related to pharmacy benefits and medication coverage.
Maintain accurate case documentation in pharmacy management systems.
Support formulary management initiatives, including step therapy and quantity limit programs.
Ensure compliance with HIPAA, client requirements, and regulatory standards.
Maintain confidentiality of protected health information.
Assist with other duties and special projects as assigned.