Pharmacy Prior Authorization Specialist

Independent Health Association; Buffalo (NY); On-site; USD 30,000 - 39,000; Full time

Benefits offered by this job

Scorecard incentive

Generous paid time off

Job summary

Independent Health Association is seeking a Prior Authorization Coordinator to manage logging in/out of prior authorizations, appeals, reimbursements, and grievances, ensuring timely resolution and regulatory compliance. The role includes supporting the pharmacy medical exception line and providing high-quality administrative support across faxing, letters, and document handling.

Occasional holidays, weekends and overtime are required.

Qualifications

• Two years of experience in pharmacy or health insurance operations or one year in Prior Authorization roles.
• Knowledge of drug names, therapeutic categories, and formulary concepts.
• Excellent communication and organizational skills.

Responsibilities

• Verify member and provider eligibility and file requests into correct folders.
• Log and ensure accuracy of prior authorization requests across systems.
• Enter data, update documentation, and transcribe decisions as needed.
• Follow up with members/providers for clinical approvals/denials within timelines.
• Handle letters, fax requests, and prepare documents for scanning.

Skills

Pharmacy knowledge

Communication skills

Time management

Problem solving

Education

High school diploma

Associates degree preferred

Tools

Pharmacy systems

Job description

Independent Health Association is seeking a Prior Authorization Coordinator to manage logging in/out of prior authorizations, appeals, reimbursements, and grievances, ensuring timely resolution and regulatory compliance. The role includes supporting the pharmacy medical exception line and providing high-quality administrative support across faxing, letters, and document handling.

Occasional holidays, weekends and overtime are required.