Medication Authorization Specialist

Winchester Cardiology and Vascular Medicine; Winchester (VA); On-site; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

Life, Disability, and Supplemental H.I

PTO

Paid Holidays

401(k) Retirement Plan with Employer 1

Employee Perks & Discount Program

Supplemental Benefits Options

Job summary

Winchester Cardiology and Vascular Medicine P.C. is seeking an Medication Authorization Specialist to support timely access to medications and manage complex administrative workflows in a busy practice.

You will coordinate prior authorizations, assist with patient financial assistance, handle forms, and communicate with providers, pharmacies, and insurers to prevent delays in care.

Qualifications

• High school diploma or equivalent required.
• At least 1 year of experience in a medical office/healthcare setting.
• Strong understanding of insurance processes and prior authorization requirements.
• Ability to manage high-volume administrative workflows with accuracy.
• Proficiency in EMR documentation (Epic preferred).
• Excellent communication with patients, providers, staff, pharmacies, and insurance companies.
• Exceptional organizational skills with ability to manage multiple tasks and deadlines.
• Strong understanding of HIPAA guidelines and patient privacy.
• Preferred: experience with medical terminology, ICD coding, medication knowledge, and pharmacy insurance benefit information.
• Preferred: experience using EMR systems (Epic).

Responsibilities

• Manage and process medication prior authorizations and appeals for physicians and APPs by coordinating requests from multiple channels, prioritizing urgency, and communicating status updates to involved parties.
• Coordinate patient financial assistance processes by facilitating applications, obtaining required documentation, securing signatures, and tracking documents to ensure timely submission.
• Oversee and complete administrative forms (e.g., FMLA, disability, DMV) by obtaining authorizations, preparing documentation for review, securing signatures, and communicating next steps to patients; ensure completion within two weeks.
• Manage in-basket workflows by regularly reviewing and prioritizing messages across categories (Urgent, Scripts, and Clinical) at multiple intervals throughout the day.
• Serve as liaison for pharmaceutical reps by maintaining directory, coordinating onsite visits, and supporting staff during sessions.
• Manage medication sample inventory by monitoring stock, coordinating replenishments, maintaining storage, and disposing of expired meds per policy.
• Complete clinic inventory and supply tracking; order supplies to maintain inventory levels.
• Maintain emergency (Code) carts by verifying expiration dates and coordinating replacements.

Skills

Epic EMR

Prior authorizations

Insurance processes

Communication skills

Organization skills

HIPAA knowledge

Medical terminology

ICD coding

Education

High school diploma or equivalent

Job description

Description

The Medication Authorization Specialist plays a vital role in supporting patient care by ensuring timely access to medications and overseeing administrative processes that are essential to treatment and continuity of care. Working collaboratively with providers, staff, pharmacies, and third-party organizations, this position manages complex workflows that require strong attention to detail and consistent follow-through. The Medication Authorization Specialist contributes to an efficient practice environment, reduces delays in care, and helps ensure patients receive the services and support needed to advance their treatment plans.

Essential Responsibilities

• Manage and process medication prior authorizations and appeals for physicians and Advanced Practice Providers (APPs) by coordinating requests received through multiple channels (e.g., CoverMyMeds, faxes, insurance correspondence), prioritizing requests based on urgency, and frequently communicating status updates to involved parties.
• Coordinate patient financial assistance processes by facilitating the completion and submission of applications including obtaining required documentation, securing signatures, and tracking returned documents to ensure timely submission.
• Oversee and complete administrative forms (e.g., FMLA, disability, DMV) by obtaining required patient authorizations, preparing documentation for provider review, securing signatures, and communicating status updates and next steps to patients, ensuring completion within established turnaround time of two (2) weeks.
• Manage in-basket workflows by regularly reviewing and prioritizing messages across designated categories (Urgent, Scripts, and Clinical) at multiple intervals throughout the day (morning, midday, and afternoon).
• Serve as the liaison for pharmaceutical representatives by maintaining an up-to-date directory, coordinating onsite visits and educational lunches, and providing support to physicians, APPs, and staff during scheduled sessions.
• Manage medication sample inventory by monitoring stock levels, coordinating with pharmaceutical representatives to replenish supplies, maintaining organized storage areas, and ensuring proper disposal of expired medications in accordance with organizational policies.
• Completes clinic inventory and supply tracking; orders supplies when necessary to maintain standard inventory counts.
• Maintain emergency (Code) carts by routinely verifying expiration dates and coordinating timely replacement of expired items.

Schedule

• Monday through Friday, 8:00 AM to 4:30 PM.

Compensation

The base pay range for this position is $17.82 - $21.50 hourly. Starting pay within the posted range is determined by factors including job-related skills, experience, education, and qualifications. The range provides the opportunity to progress as you grow and develop within a role.

Benefits

Winchester Cardiology offers a comprehensive benefits package, available upon eligibility, including:

• Medical, Dental, and Vision Insurance
• Life, Disability, and Supplemental Health Insurance
• Paid Time Off (PTO)
• Paid Holidays
• 401(k) Retirement Plan with Annual Employer Contribution
• Employee Perks & Discount Program
• Supplemental Benefits Options

Minimum Qualifications

• High school diploma or equivalent required.
• At least one year of experience working in a medical office, clinic, or healthcare setting.
• Strong understanding of insurance processes and prior authorization requirements.
• Ability to manage high-volume administrative workflows with accuracy.
• Proficiency in EMR documentation (Epic preferred).
• Excellent communication with patients, providers, staff, pharmacies, and insurance companies.
• Exceptional organizational skills with the ability to manage multiple tasks and deadlines.
• Strong understanding of HIPAA guidelines with the ability to maintain strict confidentiality and privacy of patient information.

Preferred Qualifications

• Previous experience with medical terminology, ICD coding, medication knowledge, and pharmacy insurance benefit information.
• Previous experience using EMR systems (Epic).

Physical Requirements

• Ability to lift and carry up to 50 lbs.
• Ability to work at a desk for extended periods (sitting), up to 8 hours per day
• Ability to use a computer and standard office equipment for extended periods, up to 8 hours per day
• Ability to work onsite Monday through Friday

All employees of Winchester Cardiology and Vascular Medicine P.C. are required to comply with company protocols regarding COVID-19 and other infectious diseases. This includes adherence to vaccination policies, safety measures, and any additional health protocols established to protect the well-being of patients, staff, and the community.

Winchester Cardiology values diversity and is committed to creating an inclusive workplace for all employees. We are an Equal Opportunity Employer and consider all applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability (physical or mental), veteran status, genetic information, or any other characteristic protected by law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us at [e-mail] to request an accommodation.

Winchester Cardiology and Vascular Medicine participates in E-Verify, the federal program for electronic verification of employment eligibility.