Prior Authorization Coordinator

Job Summary

Coordinating the prior authorization process, the full-time remote Prior Authorization Coordinator will manage documentation, analysis, and reporting related to pharmacy benefits while collaborating with internal teams, vendors, and healthcare providers.

Key responsibilities

• Administer the prior authorization process, providing necessary correspondence and documentation for decision-making and resolution of requests
• Assist with testing new system benefit setups and maintain up-to-date procedural documentation
• Provide support for escalated issues and analyze benefit questions for correction and resolution

Required qualifications

• Bachelor's degree in a related field or five years of pharmacy or healthcare operations experience in lieu of a degree
• Minimum three years of pharmacy operations experience, preferably with prior authorization requests
• Knowledge of pharmacy benefits management and healthcare delivery systems
• Proficiency in Microsoft Access, Excel, PowerPoint, and Word
• Ability to work independently and collaboratively within a team environment