Pharmacy Technician – Medication Management, Prior Authorization

Cleveland Clinic

. Process prescription claims and conduct initial benefits investigations .

Posted 10/27/2026full-timeUnited StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in processing prescription claims, conducting benefits investigations, and managing prior authorizations while ensuring compliance with pharmacy regulations. Proficient in utilizing pharmacy systems for patient management and communication with third-party payers.

Highest-signal resume keywords

Certified Pharmacy Technician (CPhT)Prior Authorization ProcessingPrescription Claims ManagementPatient Assistance ProgramsPharmacy Systems Utilization

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prescription ProcessingBenefits InvestigationPrior Authorization Chart ReviewsMedication VerificationInsurance Issue ResolutionData EntryPatient Profile ReviewMedication Changes IdentificationRefill ManagementAppeals Processing

Soft Skills

CommunicationCustomer ServiceProblem-SolvingMultitaskingAttention to Detail

Tools & Technologies

Pharmacy Computer Systems

Certifications & Qualifications

Certified Pharmacy Technician (CPhT)Active Registration with Ohio Board of Pharmacy

Industry Keywords

MedicareMedicaidPBMsPPOsPharmacy Technician TraineeRegistered Pharmacy TechnicianPharmacy Technician Training Program

About the role

Key responsibilities & impact

Process prescription claims and conduct initial benefits investigations
Assist with copay assistance and patient assistance programs
Complete prior authorization chart reviews to identify medication changes
Process prescriptions in computer systems
Manage incoming phone calls while balancing daily tasks
Initiate prior authorizations and communicate with third-party payers on behalf of physicians and patients
Reach out to patients to manage refills and schedule current and future assessments
Verify patient, drug, quantity, directions, day’s supply, insurance, and physician data for prescription accuracy
Process prior authorizations and appeals for pharmacy claims
Explain benefit coverage and financial responsibilities to patients
Resolve specialty pharmacy insurance issues involving Medicare, Medicaid, PBMs, and PPOs
Utilize pharmacy systems to review patient profiles, enter changes, and establish assessment schedules
Document patient, client, and provider contacts in appropriate computer systems

Requirements

What you’ll need

Applicants must reside in Ohio or Florida
High School Diploma/GED
Upon hire, must be a Certified Pharmacy Technician (CPhT) through the Pharmacy Technician Certification Board (PTCB) or the National HealthCareer Association (NHA)
Upon hire, required to hold an active registration through the Ohio Board of Pharmacy (OBOP) as either a Certified Pharmacy Technician, Registered Pharmacy Technician, or Pharmacy Technician Trainee
Caregivers with active Pharmacy Technician Trainee or Registered Pharmacy Technician registrations must update their registration to a Certified Pharmacy Technician registration with the OBOP within 6 months
Ability to perform the job while standing, reaching, stretching, stooping, and sitting for prolonged times
Manual dexterity sufficient to perform computer and dispensing functions
Ability to lift up to 20 pounds while walking, stooping, bending, and reaching
Must follow standard precautions using personal protective equipment as required
Must comply with annual influenza vaccination or obtain an approved exemption
Preferred: Completion of a formal pharmacy technician training program
Preferred: One year of experience in a pharmacy technician role

Benefits

Comp & perks

Work-from-home role
Professional growth opportunities within Pharmacy and Cleveland Clinic
Monday through Friday schedule
No weekends or holidays required