Pharmacy Prior Authorization Coordinator I

Sentara Hospitals • Virginia Beach, VA

7d • Remote

About The Position

The Pharmacy Prior Authorization Coordinator I is responsible for delivering high-quality customer service by answering and managing calls from members, provider offices, and pharmacies. This role supports the processing of prior authorization (PA) requests for pharmacy benefit medications, ensuring accuracy, compliance with regulatory and clinical guidelines, and alignment with client performance standards. Works under general supervision, using established protocols and systems to support timely, efficient, and accurate PA determinations.

Requirements

• HS Diploma or equivalent
• Must be a licensed Pharmacy Technician or a Certified Medical Assistant to qualify for this position
• Virginia Pharmacy Tech License (Required) and CPhT License (Received through the NHA or PTCB) (Required) OR Certified Medical Assistant (CMA), or Registered Medical Assistant (RMA), or Certified Clinical Medical Assistant (CCMA)
• 1 year of healthcare administrative experience (Required).

Nice To Haves

• 1 year of Managed Care, Health Plan, or PBM experience preferred.
• 1 year of Pharmacy Call Center or Authorization experience preferred.

Responsibilities

• Answering and managing calls from members, provider offices, and pharmacies.
• Supports the processing of prior authorization (PA) requests for pharmacy benefit medications.
• Ensuring accuracy, compliance with regulatory and clinical guidelines, and alignment with client performance standards.
• Works under general supervision, using established protocols and systems to support timely, efficient, and accurate PA determinations.

Benefits

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED