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Prior Authorization Specialist
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Summary: The Remote Pharmacy Tech/MA supports healthcare providers and patients by managing the complete lifecycle of Prior Authorizations (PAs), utilizing digital tools to ensure efficient processing, accurate documentation, and timely medication access from a home-based office. 


Duties and Responsibilities:

  • Manage and process all steps of the Prior Authorization workflow, from initiation to resolution, for various medications.
  • Collaborate digitally with physician offices, pharmacies, insurers, and internal teams via phone, email, and online portals to expedite PAs.
  • Communicate directly with payers (insurers) and pharmacies to resolve coverage issues and fulfill requirements.
  • Accurately document all PA activities, status updates, and communications in the electronic system.
  • Maintain strict adherence to HIPAA and company compliance standards in a virtual environment. 


Position Requirements:

  • Must possess proven self-motivation, strong time management, and excellent problem-solving skills for independent remote work.
  • Must have a dedicated home office space, reliable high-speed internet, and proficiency with digital communication/workflow tools.
  • High School Diploma required; Pharmacy Technician (CPhT) or Medical Assistant (CMA/RMA) certification/training preferred, with formal training in healthcare software highly valued. 
  • Proven experience in pharmacy, insurance verification, or physician practice support (especially PAs/reimbursement); experience with remote healthcare roles highly desirable. 
  • Proficiency in EMR/EHR systems, strong data entry, and ability to quickly learn new software.


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