Prior Authorization Coordinator (Remote)

This position is posted by Jobgether on behalf of Medical Review Institute. We are currently looking for a Prior Authorization Coordinator in the United States.

As a Prior Authorization Coordinator, you will play a vital role in managing and processing medication authorization requests efficiently and accurately. This is a remote opportunity suited for individuals with strong attention to detail, a background in pharmacy or healthcare administration, and a passion for delivering outstanding service. You'll collaborate with clinical pharmacists, physicians, and healthcare partners to ensure high-quality, timely decision-making that supports patient care and compliance. If you thrive in a fast-paced environment and are driven by precision and purpose, this role is an excellent fit.

Accountabilities:

• Process prior authorization (PA) requests in compliance with client-specific guidelines and turnaround times.
• Enter and prioritize PA information, ensuring accuracy and adherence to performance guarantees.
• Investigate formulary alternatives, assess medication history, and use drug references to validate indications.
• Collaborate with clinical pharmacists, escalating cases that require medical decisions beyond administrative processing.
• Communicate with members, physicians, and pharmacies to gather missing details or clarify pending requests.
• Accurately document decisions, status updates, and communication trails.
• Identify process improvements and participate in quality initiatives and compliance programs.
• Maintain confidentiality and follow HIPAA protocols.
• Support feedback cycles and continuously improve performance.

Requirements

• High school diploma or equivalent; active Certified Pharmacy Technician license (state or national).
• At least 1 year of prior authorization experience preferred.
• Experience in a health plan or Pharmacy Benefit Manager setting is a plus.
• Strong understanding of medication and disease states within pharmacy practice scope.
• High computer literacy (Microsoft Word, Excel, Adobe) and data entry proficiency.
• Excellent organizational, communication, and critical thinking skills.
• Proven ability to prioritize, meet deadlines, and handle multiple tasks simultaneously in a remote work setting.
• Strong customer service orientation with professional written and verbal communication.

Benefits

• Competitive salary based on experience.
• Remote work flexibility with equipment reimbursement.
• Comprehensive health, dental, and vision insurance.
• Generous paid vacation, sick leave, and paid holidays.
• 401(k) plan with company match.
• Ongoing training, growth opportunities, and employee recognition programs.
• Supportive team culture and compliance-focused environment.

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.
When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly.
🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements.
📊 It compares your profile to the job’s core requirements and past success factors to determine your match score.
🎯 Based on this analysis, we automatically shortlist the 3 candidates with the highest match to the role.
🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed.

The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role.
Once the shortlist is completed, we share it directly with the company that owns the job opening.
The final decision and next steps (such as interviews or additional assessments) are then made by their internal hiring team.

Thank you for your interest!

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