Pharmacy Prior Authorization Technician I

Page Mechanical Group, Inc.; Portland, Northern (OR, KY); Hybrid; USD 44,000 - 52,000; Full time

Benefits offered by this job

Medical benefits

401K matching

FSA

Employee Assistance Program

PTO and Holidays

Job summary

Moda Health in Portland, Oregon, is seeking a Pharmacy Prior Authorization Specialist to process PAs using the electronic PA platform, ensuring data is entered accurately for successful claims adjudication.

The role is full-time and on-site in Portland, requiring attention to detail, knowledge of formularies and benefit contracts, and the ability to work with clinical and operations teams to support members and providers.

Qualifications

• High School diploma or equivalent required; college degree preferred.
• Minimum one year in prior authorization or technician role in pharmacy/health plan.
• State Pharmacy Technician license required for external applicants; internal must obtain within six months.

Responsibilities

• Enter PA data into multiple systems and track requests.
• Assess PA requests using established criteria and provide initial determinations.
• Interpret formulary coverage and review PA requests per plan benefits.
• Triage requests to clinical team and prepare documentation for outcomes.
• Communicate PA decisions to providers, members, and internal teams.

Skills

High School diploma

College degree preferred

Microsoft Word

Microsoft Excel

Data entry

Attention to detail

Education

High School diploma or equivalent

College degree preferred

Tools

Microsoft Word

Microsoft Excel

Job description

Moda Health in Portland, Oregon, is seeking a Pharmacy Prior Authorization Specialist to process PAs using the electronic PA platform, ensuring data is entered accurately for successful claims adjudication.

The role is full-time and on-site in Portland, requiring attention to detail, knowledge of formularies and benefit contracts, and the ability to work with clinical and operations teams to support members and providers.