Prior Authorization Specialist I

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

Benefits offered by this job

Medical / Dental / Vision / Wellness

PTO / Company Holidays

Incentive Compensation

401K with Company match

Life and Disability Insurance

Tuition Reimbursement

Employee Referral Bonus

Job summary

MedImpact Healthcare Systems, Inc. is hiring for a Prior Authorization Operations role to process PA requests, validate information, and ensure timely, accurate determinations following clinical guidelines and client requirements.

The position emphasizes collaboration with clinical pharmacists, documentation of PA actions, and adherence to turnaround times while delivering high-quality service to providers and members.

Qualifications

• GED/HS Diploma and 1+ year experience or equivalent combination of education and experience.
• Maintains a current Pharmacy Technician License and/or CPhT certification without restriction.

Responsibilities

• Process and finalize Prior Authorization (PA) requests within turnaround time; enter PAs into the system and prioritize requests.
• Check formulary alternatives, review tried and failed medications; verify indication and approval for the condition.
• Document PA outcomes and respond to requests by faxing status to physicians or pharmacies.
• Coordinate with clinical pharmacists to ensure proper boundaries between PA processing and clinical decision making.

Education

GED/HS Diploma

Tools

MS Office

Job description

MedImpact Healthcare Systems, Inc. is hiring for a Prior Authorization Operations role to process PA requests, validate information, and ensure timely, accurate determinations following clinical guidelines and client requirements.

The position emphasizes collaboration with clinical pharmacists, documentation of PA actions, and adherence to turnaround times while delivering high-quality service to providers and members.