Prior Authorization Specialist I - Path to Growth

MedImpact Healthcare Systems, Inc.; Tempe (AZ); On-site; USD 24,369 - 37,760; 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 Processor to join our on-site operations team. This non-exempt role processes PA requests, uses clinical guidelines, and collaborates with clinicians and clients to ensure timely, accurate determinations.

The position emphasizes attention to detail, strong communication with physicians and pharmacies, and adherence to client performance commitments. We offer comprehensive benefits and a supportive PBM environment.

Qualifications

• GED/HS Diploma and 1+ year experience or equivalent combination of education and experience
• Intermediate knowledge of MS Office/Word, Excel, and Outlook
• Must successfully complete one of the national certification exams OR obtain state licensure; Pharmacy Technician License and/or CPhT certification
• Ability to interpret instructions, define problems, collect data, and communicate effectively

Responsibilities

• Process and finalize Prior Authorization (PA) requests within clients’ turnaround time and Performance Guarantees utilizing guidelines.
• Enter PAs into the system and prioritize requests; review formulary alternatives and verify indications.
• Collaborate with clinical pharmacists to ensure adherence to boundaries and timeframes of administrative processing.
• Coordinate notifications to members, physicians, and pharmacies and document status; respond to inquiries about PA status.

Skills

MS Office/Word

Excel

Outlook

Education

GED/HS Diploma

Tools

MS Office

Windows-based databases

Job description

MedImpact Healthcare Systems, Inc. is seeking a Prior Authorization Processor to join our on-site operations team. This non-exempt role processes PA requests, uses clinical guidelines, and collaborates with clinicians and clients to ensure timely, accurate determinations.

The position emphasizes attention to detail, strong communication with physicians and pharmacies, and adherence to client performance commitments. We offer comprehensive benefits and a supportive PBM environment.