Pharmacy PA Specialist — Faster Patient Access

Whole Family Health Center; Florida; On-site; USD 45,000 - 65,000; Full time

Job summary

Whole Family Health Center is seeking a Pharmacy Prior Authorization Specialist to manage patient prior authorizations for medications both in-house and at external pharmacies. The role collaborates with providers, pharmacy staff, and insurers to obtain approvals, resolve billing issues, and suggest formulary alternatives when appropriate.

The ideal candidate has strong knowledge of medical terminology, prescription medications, and HIPAA compliance, with excellent communication skills in

Qualifications

• High school diploma or GED required.
• Proficiency with pharmacy management systems and EMR.
• Experience with electronic billing platforms and MS Office.
• Tailored knowledge of drug terminology and insurance billing processes.

Responsibilities

• Manage prescription prior authorizations for clinic patients.
• Collaborate with providers to obtain clinical documentation.
• Resolve formulary requirements and suggest alternatives when needed.
• Monitor insurance rejection queues and assist with billing issues.
• Coordinate with staff to ensure timely approval and dispensing.
• Provide phone support for pharmacy operations as needed.
• Assist leadership with operational duties.

Skills

Attention to detail

Communication skills

Problem solving

Spanish or Creole language ability

Education

High school diploma or GED

Tools

Pharmacy management systems

EMR systems

Microsoft Office

Electronic billing platforms

Job description

Whole Family Health Center is seeking a Pharmacy Prior Authorization Specialist to manage patient prior authorizations for medications both in-house and at external pharmacies. The role collaborates with providers, pharmacy staff, and insurers to obtain approvals, resolve billing issues, and suggest formulary alternatives when appropriate.

The ideal candidate has strong knowledge of medical terminology, prescription medications, and HIPAA compliance, with excellent communication skills in