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Senior Pharmacy Prior Authorization Representative

Work from home Full-time role Hiring

Job Description:

  • Support a designated group of clinics and manage prior authorizations using internal and external pharmacy and clinic systems
  • Enter prescriptions, adjudicate claims, resolve rejections, and process orders accurately
  • Use clinic-specific EMR systems to gather information needed for prior authorizations
  • Handle benefit checks, prior authorization submissions, follow-ups, and appeals
  • Research and respond to benefit and processing questions from internal sales, patients, and providers
  • Maintain compliance with contract requirements and company practices
  • Manage multiple tasks while maintaining strong attention to detail and communication
  • Participate in customer meetings, training sessions, and other program-related projects

Requirements:

  • High school diploma or GED required
  • 2+ years of Pharmacy Technician experience
  • National Pharmacy Technician certification required
  • Active pharmacy technician license in AZ
  • Strong Microsoft Office, data entry, math, and communication skills
  • High attention to detail with the ability to multitask across phone and computer-based work
  • Experience with CoverMyMeds or similar electronic prior authorization tools preferred
  • Experience with appeals, denials, EMR systems, or infertility care is a plus
  • Strong teamwork, ownership, and time management skills

Benefits:

  • medical
  • vision
  • dental
  • well-being and behavioral health programs
  • 401(k)
  • company paid life insurance
  • tuition reimbursement
  • a minimum of 18 days of paid time off per year
  • paid holidays

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