Pharmacy Access & Prior Authorization Specialist

Memorial Healthcare System; Miramar Beach (FL); On-site; USD 52,000 - 72,000; Full time

Job summary

Memorial Healthcare System in Miramar, FL, seeks a Pharmacy Benefits Analyst to support benefit coverage investigations, authorize prior authorizations, and help patients obtain financial assistance for medications.

The role coordinates enrollment and ongoing eligibility for manufacturer patient assistance programs, prepares savings reports, and ensures compliance with regulatory requirements while working with providers and payers to secure access to therapies.

Qualifications

• High School Diploma or Equivalent (Required)
• Certified Pharmacy Technician (CPHT) - Pharmacy Technician Certification Board (PTCB)
• Registered Pharmacy Technician (RPT LICENSE) - State of Florida (FL)

Responsibilities

• Performs pharmacy benefit investigation and applies knowledge of coverage rules by third party payers.
• Identifies therapies requiring certification of medical necessity.
• Works with providers and payers to obtain approval and initiates support for denials or appeals.
• Processes patient financial documentation for pharmacy financial assistance eligibility.
• Tracks status of reimbursements and coordinates renewals and program enrollments.

Skills

Pharmacy benefit investigations

Financial counseling

Customer service

Payer coordination

Regulatory compliance

Education

High School Diploma or Equivalent

Certified Pharmacy Technician (CPHT)

Registered Pharmacy Technician (RPT)

Job description

Memorial Healthcare System in Miramar, FL, seeks a Pharmacy Benefits Analyst to support benefit coverage investigations, authorize prior authorizations, and help patients obtain financial assistance for medications.

The role coordinates enrollment and ongoing eligibility for manufacturer patient assistance programs, prepares savings reports, and ensures compliance with regulatory requirements while working with providers and payers to secure access to therapies.