Senior Pharmacy Prior Authorization Representative
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Pharmacy Prior Authorization Senior Representative at Cigna Group supporting patients with prior authorizations and insurance benefits. Handle submissions, claims resolutions, and help with the order process.
Responsibilities:
- Support a designated group of clinics and manage prior authorizations using internal and external pharmacy and clinic systems
- Enter prescriptions, adjudicate claims, resolve rejections, and process orders accurately
- Use clinic-specific EMR systems to gather information needed for prior authorizations
- Handle benefit checks, prior authorization submissions, follow-ups, and appeals
- Research and respond to benefit and processing questions from internal sales, patients, and providers
- Maintain compliance with contract requirements and company practices
- Manage multiple tasks while maintaining strong attention to detail and communication
- Participate in customer meetings, training sessions, and other program-related projects
Requirements:
- High school diploma or GED required
- 2+ years of Pharmacy Technician experience
- National Pharmacy Technician certification required
- Active pharmacy technician license in AZ
- Strong Microsoft Office, data entry, math, and communication skills
- High attention to detail with the ability to multitask across phone and computer-based work
- Experience with CoverMyMeds or similar electronic prior authorization tools preferred
- Experience with appeals, denials, EMR systems, or infertility care is a plus
- Strong teamwork, ownership, and time management skills
Benefits:
- medical
- vision
- dental
- well-being and behavioral health programs
- 401(k)
- company paid life insurance
- tuition reimbursement
- a minimum of 18 days of paid time off per year
- paid holidays
Similar Jobs
Clinical Pharmacist – Medicare STARS
Clinical Pharmacist for Medicare STARS providing pharmaceutical care and counseling to SHP members. Managing medication-related gaps in care and collaborating with health plan teams.
Pharmacy Adjudication Specialist
Adjudication Specialist managing real time insurance claims while providing customer service to clients. Ensuring compliance with federal and state regulations for CommuniCare Family of Companies.
Senior Pharmacy Resolution Specialist
Senior Pharmacy Resolution Specialist acting as a subject matter expert on pharmacy issues. Handling escalated calls and providing resolutions for healthcare providers and members.
Pharmacy Technician Associate
Remote Pharmacy Technician responsible for managing order flow and supporting pharmacists at PipelineRx. Requires excellent communication skills and national pharmacy technician certification.
Inpatient Telepharmacist, Third Shift
Telepharmacist at The Cigna Group delivering high-quality, patient-centered care across hospitals using technology. Collaborating with clinical teams to enhance medication management and patient outcomes remotely.
Utilization Management Clinical Pharmacist 2
Clinical Pharmacist responsible for medication reviews and patient advisement. Part-time remote position for a healthcare company with flexible hours and variable staffing.
Antimicrobial Stewardship Pharmacist
Infectious Diseases pharmacist working with Nebraska Medicine's ASAP program. Collaborating on antimicrobial stewardship efforts alongside healthcare professionals.
Senior Pharmacy Consultant – Health Care
Pharmacy Consultant/Pharmacy Domain Specialist at EY with a focus on pharmacy operations. Analyzing workflows and supporting healthcare consulting engagements in a collaborative environment.
Clinical Review Pharmacist
Clinical Pharmacist processing Utilization Management requests for a clinical staffing firm at UNITAS. Responsible for clinical evaluation, consultation with health care providers, and promoting decision consistency.
Clinical Pharmacist
Clinical Pharmacist at Sentara Health providing comprehensive pharmaceutical care for patients. Requires a Bachelor’s in Pharmacy and experience in managed care as well as a valid FL license and willingness to obtain VA license.
Certified Pharmacy Technician – Outreach
Certified Pharmacy Technician providing remote pharmacy support services at AnewHealth. Responsible for patient billing, coordination, and exceptional customer service in a fast-paced environment.
Lead Pharmacy Technician – User Acceptance Testing
Lead Pharmacy Technician responsible for validating the Patient First platform functionality. Ensuring high-quality patient care and operational readiness in a remote pharmacy environment.
Certified Pharmacy Technician
Pharmacy Technician providing customer service and processing prescriptions for ExactCare Pharmacy. Working in a fast-paced environment to support patients nationwide with pharmacy services.
Senior Specialty Consultative Pharmacist
Senior Specialty Consultative Pharmacist providing clinical support to patients via telephonic interactions. Focus on medication therapy assessment and comprehensive care plans in a remote role.
Pharmacy Technician
Pharmacy Technician managing medication services, fostering safety and efficiency in pharmaceutical care for diverse service populations. Collaborating with healthcare providers and maintaining compliance with regulations.
Pharmacy Technician Associate Representative, Inbound Phones
Pharmacy Technician handling inbound patient calls for Accredo Specialty Pharmacy, based in Indiana, Florida, or Ohio. Assisting in medication management for patients with chronic diseases.
Director, Pharmacy Client Management
Director leading a team of account executives to ensure client satisfaction and retention. Collaborating with senior leadership and cross-functional teams at CVS Health.
Prior Authorization Pharmacist
Prior Authorization Pharmacist reviewing medication requests for compliance with clinical guidelines. Collaborating with providers and internal teams to enhance utilization management processes.
Pharmacy Technician
Pharmacy Technician supporting patients and providers by managing prescription intake and clarification. Working remotely while answering calls and documenting prescriptions accurately at Express Scripts.
Consultative Pharmacist
Consultative Pharmacist providing optimal medication therapy and patient care consultation. Engaging with patients and providers to ensure safe medication usage and health improvement.