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Prior Authorization Specialist

7/11/2025

No location specified

Job Summary

A company is looking for a Specialist I, Prior Authorization.

Key Responsibilities
  • Review, process, and troubleshoot incoming Prior Authorization requests for medications
  • Communicate prior authorization criteria to providers and assist them in submitting requests
  • Maintain compliance with regulatory guidelines and departmental performance metrics
Required Qualifications, Training, and Education
  • High school degree or equivalent; post high school education such as L.P.N. or Certified Pharmacy Technician is desired
  • Previous customer service experience is required
  • Previous data entry experience is preferred
  • Experience in health insurance/pharmacy insurance or managed care organization is preferred
  • Prior authorization processing experience is desired

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