Senior Pharmacy Prior Authorization Specialist

Evicore Healthcare; Newburyport (MA); Teletrabalho; USD 26 000 - 40 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Annual bonus plan

Health benefits

401(k)

Resumo da oferta

The Cigna Group is seeking a Pharmacy Prior Authorization Senior Representative to join a specialized team focused on high-touch programs for patient benefits and prior authorizations. You will handle EMR usage, claims adjudication, and communications with patients, providers, and internal teams, while maintaining accuracy and customer service focus.

This role offers remote or hybrid work options with an hourly rate of 19–29 USD, depending on experience and location, plus eligibility for an

Qualificações

• High School Diploma or GED required.
• 2+ years of Pharmacy Technician experience.
• National Pharmacy Technician certification required.
• Active MA/AZ/IL licenses required.
• Proficient in Microsoft Office and data entry.
• Strong math for prescription calculations.
• Excellent attention to detail and quality.
• Strong verbal and written communication skills.
• Able to multitask in PC/phone tasks.
• 1+ year experience with prior authorization submissions (CoverMyMeds).
• Experience with prior authorization appeals and denials.
• Experience with EMR systems; infertility experience a plus.
• Team oriented; ownership and reliability on projects.

Responsabilidades

• Enter prescriptions into our system and adjudicate claims.
• Use clinic EMR to gather information for prior authorizations.
• Submit prior authorizations, follow up and appeals as needed.
• Investigate processing/benefit inquiries from the Fertility Inside Sales team.
• Handle insurance inquiries and benefit checks.
• Communicate with patients, providers, and internal teams about benefits.
• Attend program meetings and training; support special projects.

Conhecimentos

Prior authorization

Pharmacy technician

Customer service

EMR systems

Communication skills

Formação académica

High School Diploma or GED

National Pharmacy Technician Certification

Pharmacy technician license (MA)

Pharmacy technician license (AZ)

Pharmacy technician license (IL)

Ferramentas

CoverMyMeds

Descrição da oferta de emprego

The Cigna Group is seeking a Pharmacy Prior Authorization Senior Representative to join a specialized team focused on high-touch programs for patient benefits and prior authorizations. You will handle EMR usage, claims adjudication, and communications with patients, providers, and internal teams, while maintaining accuracy and customer service focus.

This role offers remote or hybrid work options with an hourly rate of 19–29 USD, depending on experience and location, plus eligibility for an