Prior Authorization Specialist [Pharmacy LOB]

Swift Up; Taguig; On-site; PHP 335,000 - 614,000; Full time

Job summary

Swift Up is seeking a pharmacare coordinator in the Philippines to support prior authorization workflows using Epic, Surescripts ePA, and CoverMyMeds. The role involves processing ePA requests, communicating denials to clinic staff within the Epic system, and maintaining high-quality turnaround times.

Responsibilities include follow-up on denials or missing information, and contacting payors via phone or payor portals as required to secure authorizations.

Qualifications

• 2–3 years retail pharmacy experience.
• Electronic prior authorization (ePA) experience in retail pharmacy.

Responsibilities

• Process prior authorizations using Epic and Surescripts ePA.
• Use Epic and CoverMyMeds as needed to process prior authorizations.
• Communicate denials to clinic staff within Epic Telephone Encounter.
• Maintain quality standards and turnaround times.
• Follow up on e-PA’s due to denials or missing information.
• Make calls to payors or use payor portals as required.

Skills

Retail pharmacy experience

ePA experience

Prior authorization workflow

Education

Retail pharmacy experience (2-3 years)

Tools

Epic

Surescripts ePA

CoverMyMeds

Job description

Key Responsibilities:

• Working within Epic and Surescripts ePA to process prior authorizations.


• Working in Epic and CoverMyMeds as needed to process prior authorizations. (Experience in EPIC is only preferred)


• Communicating denials to clinic staff within Epic Telephone Encounter.


• Maintaining quality standards and turnaround times.


• Follow up on e-PA’s due to denials or missing information.


• Calls to payor as required (or) use payor portals as required.

Required Education and Experience

• 2-3 years retail pharmacy


• Retail Pharmacy electronic prior auth experience