Prior Authorization Specialist I

medimpact; Tempe (AZ); On-site; USD 24,000 - 38,000; Full time

Job summary

MedImpact Healthcare Systems, Inc. seeks a Prior Authorization Specialist to process PA requests in line with clinical protocols and client guidelines.

You will use various systems to gather information, verify indications, and determine approvals, pendings, or referrals as needed. The role requires interaction with physicians, pharmacies, and internal teams to ensure accurate and timely adjudication, while documenting all related information and outcomes for quality and compliance.

Qualifications

• Experience with prior authorization processing and clinical protocols.
• Ability to review formulary alternatives and verify drug indications.
• Strong attention to detail and documentation skills.

Responsibilities

• Process prior authorization requests within client turnaround times and performance guarantees.
• Coordinate with clinical pharmacists and physicians to resolve PA issues.
• Document PA decisions and communicate status to providers and pharmacies.

Skills

PA processing

Analytical thinking

Communication

Tools

EMR systems

Job description

MedImpact Healthcare Systems, Inc. seeks a Prior Authorization Specialist to process PA requests in line with clinical protocols and client guidelines.

You will use various systems to gather information, verify indications, and determine approvals, pendings, or referrals as needed. The role requires interaction with physicians, pharmacies, and internal teams to ensure accurate and timely adjudication, while documenting all related information and outcomes for quality and compliance.