Remote Prior Authorization Specialist – Pharmacy Benefits

Medix™; United States; Remoto; USD 28.000 - 32.000; Tempo integral

Benefícios oferecidos por esta vaga

Remote work

Equipment provided

Resumo da vaga

Medix™ is seeking a remote Prior Authorization Specialist with experience in PBM, health plan operations, and PA workflows. This role focuses on reviewing PA requests, coordinating with providers and pharmacies, and documenting decisions to support medication access.

Top performers may transition into a permanent role based on performance. The position offers full remote work with standard hours, and a competitive hourly rate of $20–$23.

Qualificações

• Experience in a PBM or health plan setting.
• Knowledge of prior authorization processes and insurance guidelines.
• Strong attention to detail and organizational skills.

Responsabilidades

• Review PA requests and determine coverage eligibility based on clinical criteria and health plan guidelines.
• Coordinate with providers, pharmacies, and members to obtain documentation and communicate determinations.
• Maintain accurate PA documentation in internal systems.

Conhecimentos

PBM experience

PA workflows

Attention to detail

Communication skills

Case management

Descrição da vaga

Medix™ is seeking a remote Prior Authorization Specialist with experience in PBM, health plan operations, and PA workflows. This role focuses on reviewing PA requests, coordinating with providers and pharmacies, and documenting decisions to support medication access.

Top performers may transition into a permanent role based on performance. The position offers full remote work with standard hours, and a competitive hourly rate of $20–$23.