Senior Pharmacy Prior Authorization Representative
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