Prescription Prior Authorization Specialist

Exceptional HR Solutions, LLC

. Utilize and comprehend eClinicalWorks, including telephone encounters, chart notes, and provider directives .

Posted 10/13/2026full-timeRemote • United StatesMid-LevelSenior💰 $19 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates proficiency in eClinicalWorks and Excel, ensuring accurate documentation and effective communication with patients, providers, and insurance companies. Knowledge of HIPAA compliance and chemical dependency is essential for maintaining patient care standards.

Highest-signal resume keywords

EClinicalWorks ProficiencyHIPAA CompliancePrior Authorization SubmissionEffective Communication SkillsKnowledge of Chemical Dependency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prior Authorization SubmissionInsurance VerificationDocumentation ManagementExcel ProficiencyOffice Work Experience

Soft Skills

Effective Verbal CommunicationEffective Written CommunicationMultitasking AbilityPositive AttitudeQuick Learning

Tools & Technologies

Electronic SystemsPersonal Computers

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

PHI LawsHIPAA42 CFR Part 2Chemical DependencyPatient Care

About the role

Key responsibilities & impact

Utilize and comprehend eClinicalWorks, including telephone encounters, chart notes, and provider directives
Verify insurance coverage and prescription formularies to ensure prescription payment
Submit prior authorizations to insurance companies via phone, fax, and electronic systems
Answer incoming calls and address patient concerns and questions regarding authorization status and process
Maintain accurate documentation of authorizations and prior approvals
Work directly with insurance companies, pharmacies, and providers to resolve authorization issues
Monitor and track established patient prescription authorizations
Work closely with providers, Ideal Option staff, and pharmacies to ensure the best patient care
Represent Ideal Option professionally and with a positive attitude
Comply with national PHI laws including HIPAA and 42 CFR Part 2
Perform other duties as assigned by supervisor

Requirements

What you’ll need

High School Diploma or GED
Experience with personal computers (word processing and/or electronic spreadsheets)
Preferably one year or more of experience in office work
Effective verbal and written communication skills
Proficiency in Excel
Ability to multitask, learn quickly, and work in a fast-paced environment
Knowledge of chemical dependency and its effects on individuals, families, and communities is required
Compliance with national PHI laws including HIPAA and 42 CFR Part 2
Continual sustained attendance

Benefits

Comp & perks

Medical, vision, and dental
Short-term and long-term disability options
Life insurance
Employee Assistance and Life Assistance programs
A 401K retirement program
Pet Insurance
Paid time off and paid holidays