Technicians spend their days reviewing prior authorization requests submitted by providers and making coverage decisions based on the information received and the criteria for the plan they review for. Once fully trained, our technicians are expected to process 30-35 cases per day for a total of 150-175 cases per week. They are also held to 95% quality standards as well.
Track and triage coverage determination requests submitted from providers and determine if a pharmacist review is required.
Obtain verbal authorizations and request detailed clinical information from prescribers.
Approve coverage determination requests based on defined criteria.
Enter and document coverage determination request decision into the PBM system and notify providers and/or members.
Respond to client inquiries regarding authorization approvals and PBM on-line applications.
Refer coverage determination requests for specialty drugs to delegated vendor or client for processing.
Contact providers for additional information to facilitate coverage determination reviews.
Notify physicians, providers and members of coverage determination request decisions.
Job Type & Location This is a Contract position based out of Phoenix, AZ. Pay and Benefits The pay range for this position is $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:
Workplace Type This is a fully remote position.
Application Deadline This position is anticipated to close on Nov 26, 2025.
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 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. 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.