Pharmacy Prior Authorization & Care Coordination Specialist

Winchester Cardiology and Vascular Medicine; Winchester (VA); On-site; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

Life, Disability, and Supplemental

Paid Time Off (PTO)

Paid Holidays

401(k) Retirement Plan with Employer**

Employee Perks & Discount Program

Supplemental Benefits Options

Job summary

Winchester Cardiology and Vascular Medicine P.C. is seeking a Medication Authorization Specialist to support timely access to medications and oversee administrative processes essential to treatment and continuity of care.

You will collaborate with providers, staff, pharmacies, and third-party organizations to manage complex workflows with meticulous attention to detail. This on-site role involves coordinating patient financial assistance, completing forms (FMLA, disability, DMV), managing

Qualifications

• High school diploma or equivalent required.
• At least one year of experience working in a medical office, clinic, or healthcare setting.
• Strong understanding of insurance processes and prior authorization requirements.
• Ability to manage high-volume administrative workflows with accuracy.
• Proficiency in EMR documentation (Epic preferred).
• Excellent communication with patients, providers, staff, pharmacies, and insurance companies.
• Exceptional organizational skills with the ability to manage multiple tasks and deadlines.
• Strong understanding of HIPAA guidelines with the ability to maintain strict confidentiality and privacy of patient information.

Responsibilities

• Manage and process medication prior authorizations and appeals for physicians and APPs by coordinating requests received through multiple channels (e.g., CoverMyMeds, faxes, insurance correspondence), prioritizing requests based on urgency, and frequently communicating status updates to involved parties.
• Coordinate patient financial assistance processes by facilitating the completion and submission of applications including obtaining required documentation, securing signatures, and tracking returned documents to ensure timely submission.
• Oversee and complete administrative forms (e.g., FMLA, disability, DMV) by obtaining required patient authorizations, preparing documentation for provider review, securing signatures, and communicating status updates and next steps to patients, ensuring completion within established turnaround time of two (2) weeks.
• Manage in-basket workflows by regularly reviewing and prioritizing messages across designated categories (Urgent, Scripts, and Clinical) at multiple intervals throughout the day (morning, midday, and afternoon).
• Serve as the liaison for pharmaceutical representatives by maintaining an up‑to‑date directory, coordinating onsite visits and educational lunches, and providing support to physicians, APPs, and staff during scheduled sessions.
• Manage medication sample inventory by monitoring stock levels, coordinating with pharmaceutical representatives to replenish supplies, maintaining organized storage areas, and ensuring proper disposal of expired medications in accordance with organizational policies.
• Completes clinic inventory and supply tracking; orders supplies when necessary to maintain standard inventory counts.
• Maintain emergency (Code) carts by routinely verifying expiration dates and coordinating timely replacement of expired items.

Skills

HIPAA compliance

Communication

Multitasking

Medical office experience

Education

High school diploma or equivalent

Tools

Epic EMR

EMR systems

Job description

Winchester Cardiology and Vascular Medicine P.C. is seeking a Medication Authorization Specialist to support timely access to medications and oversee administrative processes essential to treatment and continuity of care.

You will collaborate with providers, staff, pharmacies, and third-party organizations to manage complex workflows with meticulous attention to detail. This on-site role involves coordinating patient financial assistance, completing forms (FMLA, disability, DMV), managing