PA Coordinator I: Prior Authorization Specialist

MedImpact Healthcare; Tempe (AZ); On-site; USD 26,000 - 42,000; Full time

Benefits offered by this job

Medical/Dental/Vision/Wellness

401K with Company match

Paid Time Off / Holidays

Tuition Reimbursement

Employee Referral Bonus

Job summary

MedImpact Healthcare Systems, Inc. is seeking a Prior Authorization Processor to join our Operations team in a detail-oriented role.

You will process and finalize PA requests, enter them into our systems, and verify information against clinical protocols and client guidelines to determine approvals, pendings, or referrals. You will coordinate with physicians, pharmacies, and internal teams to obtain missing data, communicate determinations, and ensure timely, accurate service.

Qualifications

• GED/HS Diploma with 1+ year experience or equivalent combination of education and experience.
• Must successfully complete one of the national certification exams OR obtain state licensure (in any U.S. State). Maintains a current Pharmacy Technician License and/or CPhT certification without restriction.

Responsibilities

• Process and finalize Prior Authorization (PA) requests within clients’ turnaround time and Performance Guarantees utilizing guidelines.
• Enter PAs into the system and prioritize requests; check formulary alternatives and review tried and failed medications.
• Coordinate notifications to members, physicians, and pharmacies to obtain missing information and communicate determinations.
• Collaborates with clinical pharmacists to ensure adherence to administrative processing timelines.
• Document PA-related information and status; respond to requests by faxing PA status to physicians or pharmacies.

Skills

Reasoning Ability

Mathematical Skills

Language Skills

Education

GED/HS Diploma

Tools

MS Office/Word

Excel

Outlook

Job description

MedImpact Healthcare Systems, Inc. is seeking a Prior Authorization Processor to join our Operations team in a detail-oriented role.

You will process and finalize PA requests, enter them into our systems, and verify information against clinical protocols and client guidelines to determine approvals, pendings, or referrals. You will coordinate with physicians, pharmacies, and internal teams to obtain missing data, communicate determinations, and ensure timely, accurate service.