Remote Prior Authorization Specialist III - Lead & Optimize

Navitus Health Solutions, LLC; United States; Remote; USD 29,000 - 35,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave

Holidays

401K

Adoption assistance

Flexible Spending Account

Educational assistance

Professional membership assistance

Referral bonus

Job summary

Lumicera is seeking a Specialist III, Prior Authorization to join our growing team. This role guides the Prior Authorization team, ensuring accurate triage, timely provider communications, and compliance with internal standards.

You will coach and train associates, manage workflow, and partner with insurers to obtain necessary approvals. The position follows a M-F schedule with remote-capable work for eligible locations.

Qualifications

• High School diploma or GED required.
• National CPhT and/or registration/licensure required per associate’s residing state’s requirements.
• 2+ years pharmacy support experience or healthcare environment experience required.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Responsibilities

• Coordinate day-to-day operations of the Prior Authorization team.
• Lead, coach and train staff to meet KPIs and quality targets.
• Assist providers and insurers with prior authorizations.
• Troubleshoot operational challenges and escalate as needed.
• Support compliance, DEI objectives, and continuous workflow improvement.
• Handle emergency requests and triage prioritizations.

Skills

CPhT credential or license

Pharmacy support experience

Team coaching

Compliance objectives

Professional communication

Education

High School diploma or GED

Job description

Lumicera is seeking a Specialist III, Prior Authorization to join our growing team. This role guides the Prior Authorization team, ensuring accurate triage, timely provider communications, and compliance with internal standards.

You will coach and train associates, manage workflow, and partner with insurers to obtain necessary approvals. The position follows a M-F schedule with remote-capable work for eligible locations.