Pharmacy PA Specialist: Fast-Track Drug Access

Paycom - ATS; Fresno (CA); On-site; USD 55,000 - 75,000; Full time

Job summary

Paycom - ATS is seeking a Prior Authorization Specialist to support the clinical pharmacy team in California. You will initiate, process, and track PA requests, gather documentation, and communicate with prescribers, payers, and internal stakeholders to ensure timely access to therapy.

The role emphasizes HIPAA compliance, detail, and adherence to clinical guidelines, with responsibilities for auditing PA activity, handling denials and appeals, and maintaining accurate records across pharmacy

Qualifications

• High school diploma or equivalent with 5+ years of retail pharmacy/PBM experience.
• Current California Pharmacy Technician license is required.
• Proficiency with pharmacy systems and insurer portals; Excel/Word skills helpful.
• Ability to apply clinical criteria to coverage requests; detail oriented.
• Strong communication and interpersonal skills; HIPAA compliance essential.

Responsibilities

• Initiate and process medication prior authorization requests per payer requirements.
• Gather, verify, and submit required clinical documentation via portals, fax, or phone.
• Enter PA updates in systems; monitor turnaround times and follow up as needed.
• Coordinate appeals and retrieve additional documentation as necessary.
• Communicate PA requirements and status with prescribers, payers, and patients.
• Audit PA activity, maintain HIPAA-compliant records, and identify process improvements.
• Prepare denial/appeal workups and templates; support audit readiness.

Skills

Retail pharmacy experience

PBM experience

HIPAA compliance

Microsoft Excel

Education

High school diploma or equivalent

California Pharmacy Technician license

Tools

Pharmacy systems

Insurer portals

Job description

Paycom - ATS is seeking a Prior Authorization Specialist to support the clinical pharmacy team in California. You will initiate, process, and track PA requests, gather documentation, and communicate with prescribers, payers, and internal stakeholders to ensure timely access to therapy.

The role emphasizes HIPAA compliance, detail, and adherence to clinical guidelines, with responsibilities for auditing PA activity, handling denials and appeals, and maintaining accurate records across pharmacy