Medication Authorization Specialist, Bend OR
About The Position
High Lakes Health Care, part of Praxis Health, is seeking a detail-oriented and knowledgeable Medication Authorization Specialist to support our healthcare team by managing the prior authorization process for prescribed medications. This role ensures that patients receive timely access to medications by coordinating with healthcare providers, insurance companies, and pharmacies while verifying coverage requirements and formularies. The ideal candidate has strong experience in medication prior authorizations, insurance policies, and healthcare documentation. Schedule: Monday - Friday, 8:00am - 5:00pm We are excited to share with you a short video that shows why the Praxis Health family is so special. Please click here: https://youtu.be/MrNWtn42prY
Requirements
- High school diploma or equivalent required; Associate’s or Bachelor’s degree in healthcare administration, pharmacy technology, or related field preferred.
- 2+ years of experience in healthcare, preferably in medication prior authorizations or pharmacy services.
- Strong knowledge of insurance plans, prior authorization workflows, formularies, and medication coverage requirements.
- Experience working with EHR systems and payer authorization portals.
- Familiarity with medical terminology, specialty medications, and clinical documentation.
- Knowledge of medication prior authorization processes
- Insurance verification and payer policy interpretation
- Formulary and medication coverage management
- Attention to detail and documentation accuracy
- Strong communication and problem-solving skills
- Ability to manage multiple cases and deadlines
Nice To Haves
- Certified Pharmacy Technician (CPhT) or similar certification is a plus.
Responsibilities
- Manage and process medication prior authorizations for prescribed treatments.
- Review patient insurance plans to determine coverage requirements, formulary restrictions, and authorization guidelines.
- Submit prior authorization requests through payer portals, electronic systems, or phone/fax as required.
- Gather and review clinical documentation needed to support authorization requests.
- Communicate with physicians, clinical staff, pharmacies, and insurance representatives to resolve authorization issues.
- Track authorization status and follow up with payers to ensure timely approvals or denials.
- Identify alternative medications when required due to formulary restrictions and coordinate with providers.
- Maintain accurate documentation of authorization activities in the electronic health record (EHR) or practice management system.
- Monitor and stay current on payer policies, medication guidelines, and regulatory changes.
- Reliable attendance and presence at work.
Benefits
- Medical, Dental, Vision with In-Network & Custom Network discounts
- 401(K) with discretionary employer match
- Paid Time Off
- Free clinical diagnostic laboratory testing performed in-house
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
