Clinical Prior Authorization Specialist

LucyRx; Las Vegas (NV); Hybrid; USD 40,000 - 55,000; Full time

Job summary

LucyRx is seeking a Clinical Call Center Team Member to handle physician and member inquiries, interpreting pharmacy benefits and confirming prior authorizations with attention to HIPAA compliance. You will document actions in the ticketing system and communicate PA outcomes to providers and members.

Role requires organization, attention to detail, and the ability to adapt in a fast-paced environment while maintaining high standards for privacy and service quality.

Qualifications

• Pharmacy Technician Certification required or equivalent.
• GED or equivalent accepted as educational background.
• Strong Microsoft Office skills (Word, Excel) and email etiquette.
• Excellent organizational and communication skills, both written and verbal.
• Ability to adapt in a fast-paced environment and manage PHI securely.

Responsibilities

• Answer calls from physicians and members and provide requested information or support.
• Interpret pharmacy benefit plans accurately and communicate plan details.
• Process prior authorization requests and document actions in the ticketing system.
• Ensure HIPAA privacy and security in all interactions.
• Meet turnaround times and quality metrics set by regulatory bodies and internal policies.
• Collaborate with care management teams to coordinate member care.

Skills

Microsoft Office

Written & verbal communication

Detail-oriented

HIPAA compliance

Education

Pharmacy Technician Certification

GED or equivalent

Tools

Ticketing system

Job description

LucyRx is seeking a Clinical Call Center Team Member to handle physician and member inquiries, interpreting pharmacy benefits and confirming prior authorizations with attention to HIPAA compliance. You will document actions in the ticketing system and communicate PA outcomes to providers and members.

Role requires organization, attention to detail, and the ability to adapt in a fast-paced environment while maintaining high standards for privacy and service quality.