PHIL is looking for a Pharmacy Technician – Prescription Routing & Claims Support to manage the full prescription lifecycle within our health-tech startup. You'll ensure efficient order resolution and high-quality patient care through expert troubleshooting, communication, and multitasking.
What You'll Do
- Troubleshoot electronic, faxed, and verbal prescriptions by routing them to appropriate channels.
- Review and update patient insurance information using payer portals and phone resources.
- Determine the need for prior authorizations using payer-specific tools and troubleshoot denials.
- Utilize reroute best practices for orders with state changes, insurance exceptions, or pharmacy rejections.
- Navigate operational platforms like BestRx, Ops Dash, and RelayHealth effectively.
- Follow reroute protocols for specific tags including non-contracted pharmacies and state shipping changes.
- Proactively document process notes with clear routing details and actions taken.
- Communicate with partner pharmacies, provider offices, and insurance carriers to resolve issues.
- Collaborate with At-Risk, Partner Management, and PPM teams to escalate orders based on system or stock issues.
- Maintain productivity in the Reroute queue, multitasking effectively during extended call hold times.
- Ensure all patient, prescriber, and partner communications are clear and professional.
What We're Looking For
- Valid Arizona or Ohio Pharmacy Technician License.
- Minimum 1 year of pharmacy technician experience, preferably in Specialty, Mail Order, PBM, or Retail.
- Working knowledge of insurance claim rejections (e.g., Reject 50/40, DUR codes).
- Working knowledge of prior authorizations, override codes, and split billing scenarios.
- Working knowledge of ICD-10 codes and drug classifications.
- Working knowledge of FSA/HSA card restrictions and processing nuances.
- Working knowledge of Medicaid/Medicare.
- Working knowledge of routing tools and reroute resolution logic.
- Ability to work efficiently with high attention to detail on complex re-routes.
- Strong written documentation and case management skills.
Nice to Have
- PTCB certification.
Technical Stack
- BestRx
- Ops Dash
- Partner Dash
- RelayHealth
Team & Environment
You will report to Operations/Pharmacy Team Leads and join a mission-driven team passionate about modernizing prescription access.
Benefits & Compensation
- Competitive compensation: $20–$24/hour (commensurate with experience).
- Full benefits including medical, dental, and vision.
- 401(k) plan.
- Hybrid work model after 90 days.
Work Mode
This is a hybrid position based in Scottsdale, AZ, offering a mix of in-office collaboration and remote flexibility.
PHIL is an equal opportunity employer.
