Prior Authorization Specialist I

MedImpact Healthcare Systems, Inc.; United States; Remote; USD 24,000 - 38,000; Full time

Benefits offered by this job

Medical / Dental / Vision / Wellness

Paid Time Off / Holidays

Incentive Compensation

401K with Company match

Life and Disability Insurance

Tuition Reimbursement

Employee Referral Bonus

Job summary

MedImpact Healthcare Systems, Inc. is seeking a Prior Authorization Operations team member to process PA requests per client standards. You will use multiple business applications to analyze, enter data, and determine approvals based on clinical guidelines and client rules.

You will collaborate with clinical pharmacists, update stakeholders, and ensure service and quality. Strong MS Office skills and 1+ year relevant experience are required, with on-site work in the United States.

Qualifications

• GED/HS Diploma required; 1+ year of experience or equivalent combination of education and experience.
• Must complete one of the national certification exams OR obtain state licensure (e.g., Pharmacy Technician/CPhT).

Responsibilities

• Process and finalize Prior Authorization (PA) requests within client turnaround times and performance guarantees.
• Enter PAs into the system and prioritize requests.
• Check formulary alternatives and review tried and failed medications.
• Document PA approvals or non-approvals and communicate status to physicians or pharmacies.
• Coordinate with clinical pharmacists and internal teams to ensure proper boundaries and timelines.

Education

GED/HS Diploma

Tools

MS Office

Excel

Outlook

Job description

MedImpact Healthcare Systems, Inc. is seeking a Prior Authorization Operations team member to process PA requests per client standards. You will use multiple business applications to analyze, enter data, and determine approvals based on clinical guidelines and client rules.

You will collaborate with clinical pharmacists, update stakeholders, and ensure service and quality. Strong MS Office skills and 1+ year relevant experience are required, with on-site work in the United States.