Pharmacy Technician Senior Representative - CarepathRx - US Remote

Position Description:

The Pharmacy Technician will support the IVC, Authorization, and Enteral Feed teams within the Specialty Pharmacy and Infusion department at CarepathRx. This role helps facilitate patient access to medications and enteral nutrition services by completing insurance verification, obtaining prior authorizations, coordinating refills and supplies, and serving as a liaison between patients, providers, dietitians, and internal teams. The technician helps ensure timely therapy delivery, resolves coverage barriers, and supports ongoing patient care through proactive communication and coordination.

Performance Objectives and Responsibilities:

Duties may include, but are not limited to, the following:

Insurance Verification and Authorization

• Verify patient insurance eligibility and confirm that medications and therapies are covered and payable.
• Research and resolve claim rejections, coverage issues, and billing discrepancies.
• Obtain and manage new and renewal prior authorizations, including medical and pharmacy authorizations for knee injections and Botox therapies.
• Process Specialty Financial Responsibility Letters (FRLs) and monitor test claims.
• Notify patients and providers when medications cannot be dispensed due to denied authorizations, missing information, therapy changes, or other barriers, and coordinate appropriate next steps.
• Cancel orders when coverage issues cannot be resolved after all available options have been exhausted.

Enteral Nutrition Coordination

• Process enteral nutrition refill requests and verify active prescriptions and insurance coverage before fulfillment.
• Contact patients to clarify refill needs, address concerns, and identify any therapy-related issues.
• Collaborate with dietitians to manage backorders, formula substitutions, patient-reported side effects, and therapy concerns.
• Coordinate shipment of enteral supplies through McKesson or SPI facilities.
• Conduct proactive refill outreach before refill due dates to support continuity of care.
• Schedule pump pickups and coordinate the return of Chartwell equipment when therapy is complete.

Qualifications and Requirements:

• National pharmacy technician certification is required.
• 2+ years of experience as a Pharmacy Technician.
• Experience with prescription processes, including entry, adjudication, refills, and renewals.
• Ability to remain flexible and adaptable while performing a variety of duties and responsibilities.
• Ability to work independently and manage responsibilities with limited oversight.
• Strong communication skills, including effective email and phone communication.
• Open availability for emergency assistance, as needed.
• Excellent interpersonal skills and the ability to collaborate with patients, providers, pharmacists, and healthcare team members.
• Proficiency with office technology tools, including Microsoft Office, internet applications, and email.
• Experience with Google G-Suite is preferred.

Physical Demands:

• This role requires typical office-based physical abilities, including viewing a computer monitor, using a keyboard, occasionally repositioning light desk equipment, and speaking by phone for extended periods.

Why Choose Us?

• Comprehensive health coverage from day one, including medical, dental, and vision coverage.
• Competitive holiday, paid time off, and overtime compensation.
• Tuition reimbursement.
• Robust 401(k) plan with company match.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 20 - 30 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.