Coverage Determination Analyst

Itac Sa/Ag • Birmingham, AL

10d • $19 • Remote

About The Position

Step into a role where your attention to detail and pharmacy knowledge directly impacts patient care and clinical operations. As a Coverage Determination Analyst, you'll play a key role in supporting the Prior Authorization Review Team, ensuring prescriptions are processed efficiently and accurately, and helping providers and patients navigate the PA process with clarity and precision.

Requirements

• Be able to do the job as described.
• Pharmacy experience in retail or call center settings.
• Prior authorization knowledge and experience.
• Strong phone skills for outbound provider communications.
• Data entry experience with strong attention to detail.

Nice To Haves

• Familiarity with PBM platforms like CVS, Express Scripts, or Optum (preferred).
• Pharmacy Technician license or certification (preferred).

Responsibilities

• Entering patient, prescription, pharmacy, prescriber, and PA information into PBM systems.
• Reviewing prior authorization requests and reaching out to physician offices for missing information.
• Finalizing requests and entering overrides accurately in PBM claims systems.
• Responding to internal and external inquiries regarding PA requests.
• Collaborating with PA Review Team, member services, account management, and clinical teams.
• Identifying and escalating issues related to the PA process.
• Upholding patient privacy and confidentiality in all interactions.

Benefits

• Flexible start times between 8:00-9:00 AM CST to fit your schedule.
• 100% remote work with the ability to work from your home in CST or MST zones.
• Long-term contract opportunity with potential for nearly a year of continued work.
• Two-week paid training to set you up for success, M-F, 8 hours/day.
• Gain valuable experience in PBM systems and prior authorization processes.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed