Pharmacy Technician Jobs in San Jose, AZ

About The Position

Requirements

• High school diploma from an accredited school or equivalent GED
• 2 years of work experience as a pharmacy technician
• Licensed Pharmacy Technician in accordance with California state requirements
• Must be eligible to work in the United States without the need for work visa or residency sponsorship
• Strong knowledge of pharmacy workflows, terminology, and reimbursement processes
• Ability to prioritize work and manage multiple assignments in a dynamic environment
• Effective communication skills with the ability to guide and support team members
• Proficiency in pharmacy systems and Microsoft Office applications

Nice To Haves

• 1 year reimbursement experience
• PBM or health care experience

Responsibilities

• Independently review, research, and resolve prior authorization requests by applying clinical criteria, established guidelines, and professional judgment within defined protocols
• Communicate coverage determinations, formulary alternatives, and prior authorization requirements to providers and internal stakeholders, ensuring clarity and accuracy in non-routine scenarios
• Manage inbound and outbound inquiries related to eligibility, benefits, claims, and prior authorizations, resolving moderately complex issues and determining appropriate next steps
• Escalate clinically complex or exception-based cases to a pharmacist, providing thorough documentation and relevant case context to support timely resolution
• Educate providers and members on claims submission processes, appeals requirements, and reimbursement guidelines across multiple networks
• Initiates, prioritize, and manage cases by accurately gathering and entering member and provider information
• Identify trends, root causes, high-risk inquiries, and workflow gaps in daily operations and recommend process improvements to enhance efficiency, quality, and consistency
• Serve as a resource to team members by providing guidance, answering process questions, and supporting onboarding activities
• Other duties as assigned

Benefits

• Benefits, Incentives and Additional Compensation