Prior Authorization & Access Coordinator

JobRx, Inc.; Gainesville (GA); On-site; USD 28,929 - 31,684; Full time

Job summary

ProMod Rx in Gainesville, GA is seeking an hourly, non-exempt Prior Authorization Specialist to manage PA requests across payer portals and communication channels to expedite patient access to therapy.

You will verify benefits, coordinate with prescribers, HUB teams, and specialty pharmacies; ensure accurate documentation while adhering to HIPAA and program policies. A minimum of 3 years in pharmacy/healthcare is expected, with HS diploma; bilingual English/Spanish a plus.

Qualifications

• Minimum 3 years of pharmacy or healthcare experience.
• Previous experience managing prior authorizations.
• Bilingual English/Spanish is a plus.

Responsibilities

• Manage complete PA lifecycle across payer portals and submission platforms.
• Coordinate with prescribers, HUB teams, and pharmacies to advance authorization.
• Verify benefits and identify PA requirements to minimize delays.
• Submit PA requests with required clinical documents and follow up proactively.
• Collaborate with providers to support first-level appeals and medical exceptions.
• Maintain compliant case documentation and audit readiness.
• Monitor renewals and reauthorizations to ensure continuity of therapy.
• Ensure HIPAA compliance and privacy when handling patient data.

Skills

Prior authorization

Medical terminology

Customer service

Bilingual English/Spanish

Data entry

Microsoft Office

Multitasking

Education

High School Graduate

PTCB/CPhT preferred

Tools

MS Office

Job description

ProMod Rx in Gainesville, GA is seeking an hourly, non-exempt Prior Authorization Specialist to manage PA requests across payer portals and communication channels to expedite patient access to therapy.

You will verify benefits, coordinate with prescribers, HUB teams, and specialty pharmacies; ensure accurate documentation while adhering to HIPAA and program policies. A minimum of 3 years in pharmacy/healthcare is expected, with HS diploma; bilingual English/Spanish a plus.