Prior Authorization Specialist

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