Pharmacy Prior Authorization Specialist (Remote)

TEKsystems • Arlington, TX

6d • $23 - $23 • Remote

About The Position

We are seeking a detail-oriented Pharmacy Prior Authorization Specialist to support a high-volume clinical operations team. This role serves as a key liaison between pharmacists, healthcare facilities, physicians, and prescription drug plans to facilitate medication access and ensure timely completion of prior authorization requests. The ideal candidate will have experience working in pharmacy operations, prior authorizations, and healthcare documentation, with a strong commitment to accuracy and customer service.

Requirements

• High school diploma or equivalent.
• Prior experience processing pharmacy prior authorizations.
• Strong knowledge of healthcare insurance, prescription benefits, and authorization workflows.
• Excellent verbal and written communication skills.
• Strong organizational skills and attention to detail.
• Proficiency with EMAR systems and healthcare documentation platforms.
• Ability to work independently in a remote environment while managing competing priorities.

Nice To Haves

• Certified Pharmacy Technician (CPhT) certification.
• Experience in specialty pharmacy, retail pharmacy, long-term care pharmacy, or managed care environments.
• Knowledge of therapeutic interchanges and medication coverage requirements.
• Experience communicating with insurance plans, healthcare providers, and clinical teams.

Responsibilities

• Serve as a primary point of contact for prior authorization requests and therapeutic interchange communications.
• Collaborate with pharmacists, healthcare facilities, physicians, and prescription drug plans (PDPs) to coordinate authorization activities.
• Research and investigate medication payment denials to identify root causes and next steps.
• Contact insurance plans and healthcare facilities to obtain additional information regarding denied claims or authorization requirements.
• Complete, submit, and track prior authorization requests in accordance with established guidelines.
• Document clinical justifications and authorization activity accurately and thoroughly.
• Maintain detailed records within EMAR and other applicable systems.
• Ensure timely follow-up on pending requests and outstanding documentation.
• Uphold quality, compliance, and service standards while managing multiple priorities.

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Career Level: Mid Level
• Education Level: High school or GED