Pharmacy Prior Authorization Specialist (Part-Time)

Truescripts-Management-Services; Washington (IN); On-site; USD 25,000 - 34,000; Part time

Job summary

TrueScripts is seeking a part-time Prior Authorization Coordinator to review and process PA requests for pharmacy claims, including ePA, fax, or provider/member submissions. You will verify documentation and obtain missing materials per benefit plan parameters under pharmacist guidance.

Applicants must reside in the Pacific time zone; the role is up to 24 hours per week and requires strong communication, multitasking, and problem-solving skills in a PBM environment.

Qualifications

• High school diploma required; two-year degree in related field preferred.
• Experience in pharmacy prior authorizations or retail pharmacy beneficial.
• Strong communication with members, offices, and pharmacies.
• Ability to learn and explain pharmacy benefit plans to members.
• Proactive in managing prior authorization queues and deadlines.

Responsibilities

• Process new/renewal prior authorization requests for specialty and non-specialty drugs with accuracy.
• Contact members, pharmacies, and physician offices by phone, email, or fax as needed.
• Ensure compliance with benefit plan parameters.
• Educate members on pharmacy benefit plan understanding and prior authorization requests.
• Monitor PA queues and update requests per guidelines.
• Resolve issues related to prior authorizations and communicate with pharmacists.
• Process automated and manual clinical review responses from ePA and pharmacists.
• Create and send denial letters to providers.
• Move approved PAs to appropriate queues.
• Perform other duties as assigned.

Skills

Communication

Multitasking

Analytical thinking

Team player

Attention to detail

Microsoft Office 365

PA navigation software

Pharmacy benefit plans explanation

Education

High school diploma

Associate degree or related field

Tools

PA navigation software

Microsoft Office 365

Job description

TrueScripts is seeking a part-time Prior Authorization Coordinator to review and process PA requests for pharmacy claims, including ePA, fax, or provider/member submissions. You will verify documentation and obtain missing materials per benefit plan parameters under pharmacist guidance.

Applicants must reside in the Pacific time zone; the role is up to 24 hours per week and requires strong communication, multitasking, and problem-solving skills in a PBM environment.