Remote Pharmacy Prior Authorization Senior Specialist

Cigna Health and Life Insurance Company; Newburyport, Boston, Chicago, Phoenix (MA, MA, IL, AZ); Hybrid; USD 26,000 - 40,000; Full time

Job summary

Cigna Health and Life Insurance Company is seeking a Pharmacy Prior Authorization Senior Representative for Freedom Fertility. This remote role can align with AZ, IL, or MA locations, with shifts to match EST business hours.

You will research benefits, submit prior authorizations, and communicate with providers, patients and internal teams to ensure accurate claims processing and efficient approvals.

Qualifications

• High School Diploma or GED required.
• 2+ years of Pharmacy Technician experience.
• National Pharmacy Technician certification required.
• Arizona, Massachusetts or Illinois State pharmacy technician license required.
• Microsoft Office proficiency and data entry skills.
• Strong math skills related to prescription calculations.
• Excellent verbal and written communication skills.
• Ability to multitask in PC/Phone tasks.
• 1+ year experience with prior authorization submission tools like CoverMyMeds.
• Experience with prior authorization appeals/denials.
• Experience with clinical EMR systems is a plus.

Responsibilities

• Enter prescriptions into the system and adjudicate claims.
• Process prior authorizations and follow up on rejections.
• Use EMR to gather information for submissions.
• Communicate clearly with patients, providers and internal teams.
• Assist with inquiries regarding benefits and approvals.
• Participate in training and special projects as needed.

Skills

Pharmacy experience

Microsoft Office

EMR systems

CoverMyMeds

Education

National Pharmacy Technician certification

Licensed in AZ MA or IL

Tools

EMR systems

CoverMyMeds

Job description

Cigna Health and Life Insurance Company is seeking a Pharmacy Prior Authorization Senior Representative for Freedom Fertility. This remote role can align with AZ, IL, or MA locations, with shifts to match EST business hours.

You will research benefits, submit prior authorizations, and communicate with providers, patients and internal teams to ensure accurate claims processing and efficient approvals.