Prior Authorizations Representative

Prior Authorization RepresentativeA rapidly expanding healthcare organization is seeking Prior Authorization Representatives to support patients navigating prescription insurance and authorization requirements. This is an excellent opportunity for professionals looking to build or expand their experience in pharmacy benefits, healthcare insurance, and specialty pharmacy operations.The Prior Authorization Representative will manage the authorization process for prescription medications by working with insurance providers, pharmacies, and physician offices. This position requires strong attention to detail, effective communication skills, and the ability to manage multiple cases while meeting established deadlines.Key responsibilities include:Review insurance and pharmacy benefit information to determine authorization requirements.Communicate with insurance carriers to clarify coverage and authorization criteria.Partner with physician offices to collect prescriptions and necessary clinical records.Evaluate submitted documentation for completeness and accuracy.Submit authorization requests through electronic insurance platforms.Track open cases and conduct timely follow-ups on pending requests.Communicate urgent case updates to appropriate internal teams.Document authorization decisions and maintain accurate case records.Process complex authorization requests and renewal cases.Monitor upcoming expiration dates and begin renewal requests in advance.Follow established quality, productivity, and compliance standards.Qualifications:Prior authorization experience is strongly preferred.Pharmacy technician experience or licensing is highly desirable.Candidates with retail pharmacy experience may be considered.Experience with pharmacy benefits, healthcare insurance, or medical office procedures is preferred.Familiarity with insurance portals and electronic authorization systems.Basic understanding of pharmacy and healthcare terminology.Strong organizational and follow-through skills.Ability to work independently and prioritize multiple assignments.Comfortable receiving feedback and learning new processes and systems.Additional details:Multiple positions are currently available.Initial training is conducted onsite for approximately four weeks.Following training, employees transition to a flexible hybrid schedule.Regular schedule is generally 2 days onsite and 3 days remote per week.Free onsite parking is available.Business casual dress environment.Upon a conditional offer of employment, the position requires a background check and drug screening.Virtual interview process.Perks:Contract-to-hire opportunity with potential for long-term employment.Comprehensive paid training and onboarding.Flexible hybrid work arrangement after training.Opportunity to gain valuable experience in specialty pharmacy and healthcare insurance.Supportive team environment with opportunities for professional development.Pharmacy technician compensation of $21/hour for licensed, non-certified technicians and $23/hour for certified pharmacy technicians.Addison Group is an Equal Opportunity Employer.

Addison Group provides equal employment opportunities (EEO) to all employees and applicants without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran, in accordance with applicable federal, state, and local laws. Reasonable accommodation is available for qualified individuals with disabilities upon request.