PBM technicians are employed by companies which provide third party administration of prescription drug programs or integrated health care services. The job titles that these individuals possess include but are not limited to Customer Service Associate, Prior Authorization Coordinator, Specialty Prior Authorization Technician, Prior Authorization Analyst, Pharmacy Technician Service Representative, Pharmacy Audit Analyst, and Operations Clinical Pharmacist. Pharmacy Benefit Management technicians primarily work in PBM business/office settings making them vastly different than Pharmacy technicians working in retail or hospital settings.
Pharmacy Benefit Management technicians play an important role in the services offered by PBMs. Often working under the supervision of a licensed pharmacist, PBM technicians provide phone and web-based support to clients enrolled in pharmacy benefits by answering questions, processing benefit claims, and maintaining patient prescription drug related data. It is the responsibility of a PBM Technician to make sure that benefit claims are processed accurately and efficiently and that patient prescription drug related data is accurately kept. This is vital to preventing health complications stemming from harmful drug interactions. Errors made by PBM technicians can result in sanctions levied by Medicare against PBM providers.
Many individuals may start their career in the PBM industry as a Pharmacy Benefit Management Technician. Some go on to become pharmacists or managers of PBM technicians. Since there is not currently a technician certification program specific to the PBM industry, many PBM providers require that their Pharmacy Benefit Management technicians be certified as Pharmacy technicians. However, Pharmacy Technician Certifications Programs are geared towards technicians practicing in retail or hospital settings which require markedly different skill sets. Therefore, it is anticipated that PBM providers will adopt policies in which the PBMCT Certification will be a requirement for employment as a Pharmacy Benefit Management Technician.