Remote Prior Authorization Specialist — Healthcare Plans

Community Care Cooperative; Boston (MA); Remote; USD 46,000 - 54,000; Full time

Job summary

Community Care Cooperative seeks a dedicated Prior Authorization Specialist to support our Pharmacy Operations in Boston, MA, with remote work options. The role centers on submitting prior authorizations for FQHCs and CPC, coordinating with providers, patients, and health center teams to streamline care.

Ideal candidates hold MA licensure as a pharmacy technician and bring strong analytical skills. Experience with PBMs, benefit investigations, and patient assistance programs is highly valued.

Qualifications

• Current MA pharmacy technician license.
• 1 year of experience submitting prior authorizations for a medical center.
• GED or High School diploma required.

Responsibilities

• Process and submit prior authorizations for FQHCs and CPC.
• Communicate with providers, patients, and health center teams.
• Investigate insurance benefits and copay assistance.
• Identify patients eligible for assistance programs and foundations.
• Document cost savings and reimbursement updates for management.
• Follow CPC policies and provide professional customer service.

Skills

Prior authorizations

Communication

Analytical skills

Organizational skills

Initiative and judgment

Education

GED or HS diploma

Tools

Microsoft Word

Excel

Job description

Community Care Cooperative seeks a dedicated Prior Authorization Specialist to support our Pharmacy Operations in Boston, MA, with remote work options. The role centers on submitting prior authorizations for FQHCs and CPC, coordinating with providers, patients, and health center teams to streamline care.

Ideal candidates hold MA licensure as a pharmacy technician and bring strong analytical skills. Experience with PBMs, benefit investigations, and patient assistance programs is highly valued.