Prior Authorization Pro: Fast-Track Patient Access

WESTERN GROWERS GROUP; Fresno (CA); Remote; USD 34,000 - 48,000; Full time

Job summary

WESTERN GROWERS GROUP is seeking a Prior Authorization Specialist in Fresno to support the clinical pharmacy program. The role initiates, processes, and tracks PA requests, gathering chart notes, lab values, and medication histories to support timely therapy access.

The ideal candidate will have significant retail pharmacy or PBM experience, a CA Pharmacy Technician license (preferred), and strong communication skills.

Qualifications

• High school diploma or equivalent.
• Minimum five years of retail pharmacy or PBM experience.
• Current California Board of Pharmacy Technician license (preferred).
• Proficiency with Excel and Word.

Responsibilities

• Initiate and process PA requests per payer requirements and internal workflows.
• Gather, verify, and submit required clinical/administrative documentation via payer portals, fax, or phone.
• Enter and maintain PA status updates in pharmacy systems; monitor turnaround times.
• Review PA denials and retrieve supporting documentation for appeals.
• Communicate PA requirements to prescribers and payer representatives; document outreach.
• Coordinate appeal submissions and track status; ensure completion per workflow.
• Maintain HIPAA-compliant documentation and identify process improvements.

Skills

PA processing

PHI compliance

Communication

Drug information

Education

High school diploma

CA Pharmacy Technician License (preferred)

Tools

Pharmacy systems

Insurer portals

MS Excel

Job description

WESTERN GROWERS GROUP is seeking a Prior Authorization Specialist in Fresno to support the clinical pharmacy program. The role initiates, processes, and tracks PA requests, gathering chart notes, lab values, and medication histories to support timely therapy access.

The ideal candidate will have significant retail pharmacy or PBM experience, a CA Pharmacy Technician license (preferred), and strong communication skills.