LPN or Certified Medical Assistant - Medication Prior Authorization Specialist

UnityPoint Health; Fort Dodge (IA); On-site; USD 55,000 - 70,000; Full time

Job summary

UnityPoint Health in Fort Dodge is seeking a Licensed Practical Nurse (LPN) or Certified Medical Assistant (CMA) to join our Administration team as a Medication Prior Authorization Specialist. This full-time role supports physicians and the clinical team by navigating payer requirements to obtain timely prior authorizations for medications, reviewing documentation, and ensuring accurate submissions in EPIC.

The position offers daytime hours, 8:00 a.m.

Qualifications

• LPN or CMA required with active state licensure or certification.
• Familiarity with payer policies and prior authorizations preferred.
• Experience in outpatient/clinical setting is a plus.

Responsibilities

• Coordinate and process prior authorization requests for prescription medications and injections.
• Review clinical documentation for completeness and payer compliance.
• Track and follow up on pending authorizations to ensure timely approvals or appeals.
• Assist with appeals and denials, gathering supporting documentation.
• Document all authorization activities in the Electronic Medical Record.
• Educate team members on payer-specific requirements and policy changes.
• Maintain up-to-date knowledge of insurance plans and formularies.
• Monitor and report on authorization trends and denials for process improvement.
• Collaborate with clinical teams to ensure timely submission of accurate requests.
• Perform as an extension of the clinical care team to support patient experience.

Skills

Prior authorization coordination

Medical terminology

EPIC knowledge

Education

Licensed Practical Nurse (LPN) – Iowa Board of Nursing

Certified Medical Assistant (CMA) – cert.

Tools

EPIC

Job description

Overview

LPN or CMA - Medication Prior Authorization Specialist

Full-time Postion With Benefits (40 Hours Per Week)

Daytime hours

The Medication Prior Authorization Specialist (Clinical) is responsible for obtaining timely prior authorizations for medications to ensure uninterrupted patient care. This role supports physicians, providers, and clinical team members in Fort Dodge by navigating insurance requirements and improving patient access to necessary medications.

• Area of Interest: LPN
• FTE/Hours per pay period: 1.0
• Department: Administration - Fort Dodge
• Shift: 8a-4:30 M-F
• Job ID: 185469

Why UnityPoint Health?

At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker’s Healthcare several years in a row for our commitment to our team members.

Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in. Here are just a few:

• Expect paid time off, parental leave, 401K matching and an employee recognition program.
• Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members.
• Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family.

With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together.

And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.

Find a fulfilling career and make a difference with UnityPoint Health.

Responsibilities

• Coordinate and process prior authorization requests for prescription medications and injections.
• Review clinical documentation to ensure completeness and compliance with payer requirements.
• Track and follow up on pending authorizations, ensuring timely approvals or appeals.
• Assist with appeals and denials, including gathering supporting documentation.
• Document all authorization activities within the Electronic Medical Record.
• Educate other team members in the clinic on payer-specific requirements and changes in authorization policies.
• Maintain up to date knowledge of insurance plans, formularies, and coverage criteria.
• Monitor and report on authorization trends and denials to support process improvement initiatives.
• Collaborate with clinical teams to ensure timely submission of accurate and complete prior authorization requests, minimizing delays in care.
• Conduct work as an extension of the clinical care team in support of excellent experience.

Qualifications

• Valid and current licensure/certification in the state of Iowa as one of the following:
• Licensed Practical Nurse (LPN) – Iowa Board of Nursing
• Certified Medical Assistant (CMA) – accredited program with certification (AAMA, NCCT, AMT, NHA, NCMA, NAHP, AAH, ARMA or NHCA)
• Prior experience in a clinical or outpatient setting preferred
• Familiarity with EPIC a plus!