Prior Authorization Specialist (Pharmacy Benefits)

TrueScripts Management Services; Washington (IN); On-site; USD 48,000 - 64,000; Full time

Job summary

TrueScripts Management Services is seeking a detail-oriented Prior Authorization Coordinator. This role handles electronic and paper PA requests, verifying documentation and guiding benefit plans with pharmacists.

You will navigate PA software and ensure timely processing from receipt to clinical review. Ideal candidates have healthcare experience, strong communication skills, and the ability to multitask and learn complex PBM processes.

Qualifications

• High school diploma required; two-year degree preferred.
• Experience in pharmacy prior authorizations or retail pharmacy helpful.
• Strong communication with members, providers, and pharmacies.
• Ability to learn and explain pharmacy benefit plans clearly.
• Proactive, organized approach to PA queues.
• Independent work style with attention to detail.

Responsibilities

• Process new and renewal prior authorization requests for drugs.
• Contact members, pharmacies, and physicians by phone, email, or fax as needed.
• Ensure compliance with benefit plan parameters and guidelines.
• Educate members on pharmacy benefit plans and PA processes.
• Manage PA queues and nursing/clinical review communications.
• Investigate and resolve issues related to prior authorizations.
• Prepare and send denial letters to providers when required.
• Move approved PAs to appropriate queues for care.
• Perform other duties as assigned.

Skills

Communication

Independent work

Multitasking

Detail oriented

Analytical thinking

Problem solving

Team player

Proactive mindset

Customer service

Education

High school diploma

Two-year degree preferred

Tools

Microsoft Office 365

Job description

TrueScripts Management Services is seeking a detail-oriented Prior Authorization Coordinator. This role handles electronic and paper PA requests, verifying documentation and guiding benefit plans with pharmacists.

You will navigate PA software and ensure timely processing from receipt to clinical review. Ideal candidates have healthcare experience, strong communication skills, and the ability to multitask and learn complex PBM processes.