Pharmacy Technician – Prescription Routing, Claims Support

Phil, Inc.

Detail-oriented Pharmacy Technician managing prescription routing and claims support for a health-tech startup. Join a mission-driven team committed to improving patient access to medications.

Posted 5/12/2026full-timeRemote • Arizona, California, Colorado, Florida, Idaho, Illinois, Iowa, Massachusetts, Missouri, Montana, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin • 🇺🇸 United StatesJunior💰 $20 - $24 per hourWebsite

About the role

Key responsibilities & impact

Troubleshooting electronic, faxed, and verbal prescriptions via routing to appropriate channels into pharmacy systems
Review and update patient insurance using payer portals and phone resources
Determining appropriate situations for a prior authorization (PAs) need via payer-specific tools; troubleshoot denials and escalations
Utilize reroute best practices for orders falling outside normal workflow, including orders with state changes, insurance exceptions, pharmacy rejections, or failed transfers
Navigate operational platforms (e.g., BestRx, Ops Dash, Partner Dash, RelayHealth, etc.) and vendor systems effectively
Follow reroute protocols for specific tags including: non-contracted pharmacies, state shipping changes, PP send-backs, transfer not received, and more
Proactively document process notes with clear routing details, claim updates, and actions taken
Communicate with partner pharmacies, provider offices, and insurance carriers to resolve issues or clarify documentation
Collaborate with At-Risk, Partner Management, and PPM teams to escalate or flag orders based on system outages, stock issues, or policy refusals
Maintain productivity in the Reroute queue even during extended call hold times (e.g., multitask during insurance calls)
Ensure all patient, prescriber, and partner communications are clear, professional, and aligned with Phil’s standards of care

Requirements

What you’ll need

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.
Working Knowledge of:
- 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

Benefits

Comp & perks

Competitive compensation and full benefits (medical, dental, vision, etc.)
401(k)
Hybrid work model after 90 days (in-office collaboration & remote flexibility)
Collaborative, mission-driven team culture focused on innovation and patient care

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

pharmacy technician experienceinsurance claim rejectionsprior authorizationsoverride codesICD-10 codesdrug classificationsFSA/HSA card processingMedicaid experienceMedicare experiencerouting tools

Soft Skills

attention to detailstrong written documentationcase managementcommunicationcollaborationproblem-solvingmultitaskingprofessionalismprocess documentationproductivity

Certifications

Pharmacy Technician LicensePTCB certification