Authorization Representative II

. Administer prior authorization requests for patients whose health plans require drug prior authorizations .

Posted 9/25/2026full-timeUnited StatesJuniorMid-Level💰 $17 - $30 per hourWebsite

Key responsibilities & impact

Administer prior authorization requests for patients whose health plans require drug prior authorizations
Review the accuracy and completeness of prior authorization information
Ensure supporting documents are present and meet company standards
Assist with medical necessity documentation to expedite approvals
Perform appropriate follow-up
Collaborate with other departments to obtain prior authorizations and appeals
Document insurance company interactions and prior authorization information in the system
Review insurance denials and submit appeals as permitted by the payor
Contact physician offices to obtain demographic information or medical data as needed

What you’ll need

HS diploma or GED
Minimum of 2 years of experience processing pharmacy prior authorizations
Minimum of 1 year of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines
Equivalent combination of education and experience may be accepted
Specialty pharmacy experience highly preferred
Medical terminology training preferred
Oncology experience preferred
Ability to work Monday–Friday
Candidates must live within a reasonable commuting distance of a posting location unless an accommodation is granted

Comp & perks