Pharmacy Technician – Prior Authorization Specialist

About the role

We are looking for a Pharmacy Technician to join our Cebu team as a Prior Authorization Specialist. In this full‑time, onsite position you will evaluate medication requests, verify clinical documentation, and ensure compliance with pharmacy benefit policies and client guidelines.

Key responsibilities

• Review prior authorization submissions and research applicable coverage criteria.
• Validate clinical documentation and apply established authorization criteria to make accurate determinations.
• Document decisions and communicate outcomes to stakeholders.
• Enter data accurately and support quality‑assurance initiatives.
• Collaborate with clinical, operational, and account teams to resolve authorization issues.
• Assist in implementing new or updated guidelines and maintain process integrity.
• Ensure compliance with regulatory and client‑specific requirements.

Required profile

• Active Pharmacy Technician license.
• Experience in prior authorization, pharmacy benefits management, managed care, or related healthcare operations.
• Strong understanding of pharmacy benefit concepts such as formularies, utilization management, and claim adjudication.
• Ability to interpret clinical guidelines and apply standard operating procedures accurately.
• High attention to detail and excellent written and verbal communication skills.
• Willingness to work onsite Monday‑Friday in Cebu.

Required skills

• Proficiency with Microsoft Excel.
• Proficiency with Microsoft Word.
• Proficiency with Microsoft Outlook.
• Experience using healthcare/pharmacy systems.