Job Description

Centralized and Standardized Native Customer Support Services Worldwide Sole provider of all Major Languages and Dialects in the World International Marketplace of Premium Contact Center Projects for Remote Talents.

Dear Visitor, welcome to our page! TalentWorldGroup is a Revolutionary Multilingual Cloud Contact Center and the International Marketplace of Premium Customer Support Projects for Remote Talents. TWG is on the mission to reinvent professional Home-Based Working, build the Workplace of the Future, and make Outsourcing Uniquely Simple and Flexible for our Clients like never before. We disrupt the Contact Center industry and aim to become the New Global Standard for International Customer Service Outsourcing and Remote Working worldwide. We understand Cultural Diversity and as a sole provider support All Major Languages and Dialects in the World. Our Core Values based Legendary Customer Service and Revolutionary Operations Model are developed around our Clients’ real needs in the digital age, enabling them to focus on their Global Business Development and take Any Language Support for granted with Consistent Quality Delivery and Target Reporting Worldwide. TWG is a people’s company and we put people first. Our Unique Corporate Culture and Employee Experience Journey allow us to attract and retain the Best International Talents and Deliver on Premium Quality in any parts of the World. In the Age of Technology, our World is becoming Smaller and Connected thought Widely Available High Performing Computing Devices and Telecom Networks. Professional Home-Based Working is no longer the Question of the Technical Ability, however the Corporate Culture, Engagement and Communication. For more Information, Please visit our Unique Website or Contact us with Confidence, Let’s Do Something Amazing together!

The Role

Position Overview:

We are hiring Certified Pharmacy Technicians for a premium medical client. This is a fully remote, work-from-home role requiring candidates to be licensed and residing in Florida, Illinois, Indiana, or Wisconsin.

Key Responsibilities:

• Review pertinent patient information and check appropriateness using clinical criteria.
• Make approval recommendations on all services that meet clinical review criteria. Refer all cases not meeting clinical criteria to pharmacist clinical reviewer.
• Practice and maintain the principles of utilization management by adhering to company policies and procedures.
• Uphold clinical integrity of pharmaceutical solutions by participating in ongoing training programs to ensure quality performance in compliance with applicable standards and regulations.
• Assist with the documentation and implementation of both written and verbal communications to physicians/prescribers and assist in the maintenance of the edits and data elements that support the edits.
• Be available for consultation on pharmacy-related questions to resolve claims submission related to medication edits.
• Contact physicians/prescribers to obtain pertinent clinical history/information.
• Provide optimum customer service through professional/accurate communication while maintaining NCQA and health plan’s required timeframes.
• Regularly review and monitor information on pended claims identified as outliers by internal and/or external analysis of pharmacy claims data.
• Support Intake call volume and order entry if necessary.
• Determine eligibility for medication reimbursement based upon established clinical criteria and clinical knowledge and enter approvals or denials in the system.
• Electronically document both written and verbal communications with physicians, their staff, cardholders, and pharmacies.
• Escalate medical exception requests to nurse, pharmacist, or physician on the utilization review clinical team when further review is necessary.

Ideal Profile

Required Qualifications:

• Active Certified Pharmacy Technician license in Florida, Illinois, Indiana, or Wisconsin (must obtain license before training starts).
• Residence in one of the above states.
• University degree (preferred but not required).
• 4 to 6 years of experience in supply chain or customer service (preferred).
• Proficiency in English with excellent written and verbal communication skills.
• Ability to multitask, prioritize, and work collaboratively in a remote team.

Technical Requirements:

• Reliable broadband internet with a LAN connection.
• Windows 10+ or macOS 11+.
• Minimum 8 GB RAM, 10GB storage, and a USB-wired headset.

Compensation & Benefits:

• Training Rate: $18/hour for the training period (1-2 days).
• Post-Training Rate: $20/hour.
• Flexible hours (30–40 hours per week).
• Opportunity for career growth and long-term cooperation.
• Gamification program with rewards and holiday pay opportunities.

Application Deadline:

Start Date: February 2025

We accept applications until: January 17, 2025.

Join us to be part of an innovative workplace, redefining remote pharmacy services.

What's on Offer?

• 100% remote based working
• A role that offers a breadth of learning opportunities
• Flexible working schedule

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