Remote Prior Authorization Specialist (CMA/Pharmacy Tech)

Medical Associates; Dubuque (IA); Hybrid; USD 40,000 - 60,000; Full time

Benefits offered by this job

Health insurance

401k

Flexible Paid Time Off

FSAs (Medical and Dependent Care)

Life insurance

Job summary

Medical Associates Health Plans is seeking a CMA or Pharmacy Tech to join as a full-time Prior Authorization Specialist in Dubuque, IA. The role supports authorization workflows, communicates with payers, and collaborates with providers to obtain necessary documentation.

The position offers a standard schedule of 8:00am–5:00pm, Monday through Friday, with potential for flexible hours and the possibility to work from home after training. A competitive benefits package accompanies the role.

Qualifications

• Two or more years of medical office, referral, scheduling, insurance verification, prior authorization, or related healthcare experience preferred.

Responsibilities

• Review prior authorization requests and gather the supporting documentation needed from the medical record.
• Submit requests to payers, monitor status, follow up as needed, and document outcomes.
• Work with providers and clinical staff to obtain missing or additional information needed to support authorization.
• Communicate authorization status and payer requests to providers and staff.
• Recognize when a request requires clinical interpretation, medical necessity review, an appeal, or other nursing judgment and elevate those cases to the appropriate nurse.
• Complete all other assigned projects and duties.

Education

CMA certification / CCMA / RMA or Pharmacy Technician Certification Board

Job description

Medical Associates Health Plans is seeking a CMA or Pharmacy Tech to join as a full-time Prior Authorization Specialist in Dubuque, IA. The role supports authorization workflows, communicates with payers, and collaborates with providers to obtain necessary documentation.

The position offers a standard schedule of 8:00am–5:00pm, Monday through Friday, with potential for flexible hours and the possibility to work from home after training. A competitive benefits package accompanies the role.