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PHIL, Inc. · 2 weeks ago

Pharmacy Technician – Prescription Routing & Claims Support

Scottsdale, AZ

Full-time

Hybrid

Entry Level

$20/hr - $24/hr

1+ years exp

Phil, Inc. is a health-tech startup based in San Francisco focused on revolutionizing prescription access. They are seeking a detail-oriented Pharmacy Technician to support the full prescription lifecycle, including insurance verification and troubleshooting prescription reroutes, ensuring efficient order resolution and best-in-class patient care.

BiotechnologyMedicalSoftware

Responsibilities

Troubleshooting electronic, faxed, and verbal prescriptions via routing to appropriate channels into pharmacy systems

Review and update patient insurance using payer portals and phone resources

Determining appropriate situations for a prior authorization (PAs) need via payer-specific tools; troubleshoot denials and escalations

Utilize reroute best practices for orders falling outside normal workflow, including orders with state changes, insurance exceptions, pharmacy rejections, or failed transfers

Navigate operational platforms (e.g., BestRx, Ops Dash, Partner Dash, RelayHealth, etc.) and vendor systems effectively

Follow reroute protocols for specific tags including: non-contracted pharmacies, state shipping changes, PP send-backs, transfer not received, and more

Proactively document process notes with clear routing details, claim updates, and actions taken

Communicate with partner pharmacies, provider offices, and insurance carriers to resolve issues or clarify documentation

Collaborate with At-Risk, Partner Management, and PPM teams to escalate or flag orders based on system outages, stock issues, or policy refusals

Maintain productivity in the Reroute queue even during extended call hold times (e.g., multitask during insurance calls)

Ensure all patient, prescriber, and partner communications are clear, professional, and aligned with Phil’s standards of care

Qualification

Pharmacy Technician LicensePTCB certificationPharmacy technician experienceInsurance claim rejectionsPrior authorizationsICD-10 codesMedicaid/Medicare experienceMultitasking abilitiesCommunicationAttention to detail

Required

Arizona or Ohio Pharmacy Technician License

Preferred

PTCB certification

Minimum 1 year of pharmacy technician experience, preferably in a Specialty, Mail Order, PBM (with Manufacturer and Insurance troubleshooting experience) or Retail setting

Working Knowledge of Insurance claim rejections (e.g., Reject 50/40, DUR codes, etc.)

Prior authorizations, override codes, and split billing scenarios

ICD-10 codes and drug classifications

FSA/HSA card restrictions and processing nuances

Medicaid/Medicare Experience

Routing tools and reroute resolution logic

Ability to work efficiently and with attention to detail, especially when handling complex re-routes

Strong written documentation and case management skills