Hybrid Prior Authorization Specialist CMA or Pharmacy Tech

TriHealth; United States; Hybrid; USD 55,000 - 70,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Tuition reimbursement

Retirement plans

Paid time off

Job summary

TriHealth Corporate Office is seeking a skilled Prior Authorization Specialist (Certified Medical Assistant or Pharmacy Technician) to join the team. This role supports patients, providers, and care teams by ensuring timely access to medications and efficient prior authorizations.

The position offers opportunities to expand clinical knowledge and collaborate with a high-performing team at the Cincinnati location.

Qualifications

• High School Degree or GED in Pharmacy; Pharmacy Technician or Medical Assistant.
• Certified Pharmacy Technician or Certified Medical Assistant desired.
• Prior experience with Epic and/or prior authorizations desirable.
• 2-3 years’ experience as Clinical Pharmacy Technician or Medical Assistant.

Responsibilities

• Coordinate all aspects of the prior authorization process with insurance verification.
• Gather necessary clinical information from EMR and communicate with patients and prescribers.
• Review PA denials and inform physicians and patients of reasons for denial.
• Serve as a subject matter expert for drug formularies and PA processes.
• Follow up with insurers on PA status and maintain documentation in EMR.

Skills

Communication skills

Interpersonal skills

Problem solving

Customer service

Education

High School Diploma or GED in Pharmacy

Pharmacy Technician certification

Medical Assistant certification

Tools

Epic EHR

Job description

TriHealth Corporate Office is seeking a skilled Prior Authorization Specialist (Certified Medical Assistant or Pharmacy Technician) to join the team. This role supports patients, providers, and care teams by ensuring timely access to medications and efficient prior authorizations.

The position offers opportunities to expand clinical knowledge and collaborate with a high-performing team at the Cincinnati location.