Remote PA LVN/LPN - Prior Authorization Specialist

A-Line Staffing Solutions; Fort Worth (TX); Remote; USD 33,000 - 39,000; Full time

Benefits offered by this job

401(k) with company match

Job summary

A-Line Staffing Solutions is seeking an experienced LVN/LPN for a fully remote Prior Authorization and Appeals role in the United States. The position supports a high-volume pharmacy benefits team with meticulous documentation and adherence to criteria.

Training runs weekdays, with post-training shifts between 8:00 AM and 7:00 PM CT. Required are an active LVN/LPN license and 2+ years PA experience in PBM, MDO, or clinical settings.

Qualifications

• Active LVN/LPN license in your state.
• Minimum 2 years PA experience in PBM/medical office or clinical setting.
• Experience applying clinical criteria and supporting documentation for PA decisions.
• Strong written and verbal communication; ability to adapt in a fast-paced environment.

Responsibilities

• Process and communicate Commercial Prior Authorizations and Appeals.
• Manage inbound/outbound calls while meeting productivity and quality expectations.
• Review clinical criteria and supporting documentation (chart notes, claims history, PA history).
• Document determinations accurately and completely.
• Escalate cases that require pharmacist/MD review per guidelines.
• Work effectively across multiple systems/tools with speed and accuracy.

Skills

LVN/LPN license

PA experience

Clinical PA criteria

Strong communication

Remote work efficiency

Tools

PBM platforms (CoverMyMeds)

Job description

A-Line Staffing Solutions is seeking an experienced LVN/LPN for a fully remote Prior Authorization and Appeals role in the United States. The position supports a high-volume pharmacy benefits team with meticulous documentation and adherence to criteria.

Training runs weekdays, with post-training shifts between 8:00 AM and 7:00 PM CT. Required are an active LVN/LPN license and 2+ years PA experience in PBM, MDO, or clinical settings.