Onsite Prior Authorization Specialist & Pharmacy Tech

JobRx, Inc.; Plano (TX); On-site; USD 50,000 - 80,000; Full time

Benefits offered by this job

Paid sick leave

Health benefits

401k

Short term disability

Term life insurance

Job summary

Medix is assisting a client in Plano, TX to hire a Prior Authorization Specialist responsible for managing the end-to-end PA lifecycle to ensure timely patient care and policy compliance.

The role is onsite, Monday–Friday, 8:30 a.m.–5:00 p.m., and requires a licensed Pharmacy Technician with retail experience; CoverMyMeds experience is a plus. Benefits are provided through Medix as the staffing partner.

Qualifications

• Must have at least 2 years of experience managing the full prior authorization lifecycle including benefit investigation, document collection, PA submission, follow-up, appeals etc.
• Experience with CoverMyMeds highly preferred.
• Licensed Pharmacy Tech with retail experience preferred.

Responsibilities

• Prepare and submit prior authorization requests through payer portals, fax, phone, or electronic systems, with required clinical and insurance documentation.
• Proactively contact insurance companies for real-time status updates and resolve delays to avoid therapy interruption.
• Interpret and resolve rejection codes, payer edits, and denials to determine next steps.
• Enter PA approval letters, authorization numbers, dates, denial documentation, and communications into CareTend and other systems.
• Review denial letters for completeness before routing to Clinical Utilization Team for appeal decisions.
• Monitor PA work queues to ensure timely follow-up and prioritization.
• Maintain detailed notes of payer interactions with outcomes and next steps per internal standards.

Skills

Prior authorization

Benefit investigation

Documentation

PA submission

Payer communication

Education

Licensed Pharmacy Tech

Tools

CareTend

Job description

Medix is assisting a client in Plano, TX to hire a Prior Authorization Specialist responsible for managing the end-to-end PA lifecycle to ensure timely patient care and policy compliance.

The role is onsite, Monday–Friday, 8:30 a.m.–5:00 p.m., and requires a licensed Pharmacy Technician with retail experience; CoverMyMeds experience is a plus. Benefits are provided through Medix as the staffing partner.