Senior Pharmacy Prior Authorization Specialist - Remote

Cigna Healthcare; New York (NY); Remote; USD 26,000 - 40,000; Full time

Benefits offered by this job

Health benefits

401(k)

Tuition reimbursement

Paid time off

Paid holidays

Life insurance

Job summary

The Cigna Group is seeking a Pharmacy Prior Authorization Senior Representative to join a dedicated team handling high-touch programs. You will research benefits, process prior authorizations, and communicate with patients, providers, and internal teams with precision.

You will work with EMR systems and CoverMyMeds for prior authorizations, appeals, and denials, ensuring accurate claims processing and excellent service across clinics.

Qualifications

• High School Diploma or GED required.
• 2+ years of Pharmacy Technician experience.
• Valid National Pharmacy Technician certification is required.
• Valid AZ, MA or IL Pharmacist Technician license required.
• Proficient in Microsoft Office and data entry.
• Strong math skills for prescription calculations.
• Exceptional attention to detail and accuracy.
• Excellent verbal and written communication skills.
• Ability to multitask between PC and phone tasks.
• Experience with prior authorization submission using CoverMyMeds or similar tools.
• Experience with prior authorization appeals/denials.

Responsibilities

• Enter prescriptions accurately and adjudicate claims.
• Use EMR to obtain information for prior authorizations.
• Submit prior authorizations and follow up as needed.
• Handle inquiries from Sales, patients and providers.
• Investigate processing/benefit inquiries quickly and thoroughly.
• Communicate benefits clearly to patients and providers.
• Participate in program meetings and trainings.
• Support special projects related to contracts.

Skills

Pharmacy Tech Experience

National Certification

State Licenses AZ MA IL

Microsoft Office

Data Entry

Math Skills

Attention to Detail

Verbal & Written Communication

Multitasking

Prior Authorization Tools

Appeals & Denials

EMR Systems

Infertility Experience (plus)

Education

High School Diploma or GED

Tools

CoverMyMeds

EMR Systems

Job description

The Cigna Group is seeking a Pharmacy Prior Authorization Senior Representative to join a dedicated team handling high-touch programs. You will research benefits, process prior authorizations, and communicate with patients, providers, and internal teams with precision.

You will work with EMR systems and CoverMyMeds for prior authorizations, appeals, and denials, ensuring accurate claims processing and excellent service across clinics.