Senior Pharmacy Prior Authorization Representative

The Cigna Group

. Research benefits and obtain prior authorizations .

Posted 11/4/2026full-timeRemote • United StatesSenior💰 $19 - $29 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in prior authorization processes, including submission and appeals, while effectively communicating pharmacy benefits to patients and providers. Proficient in using EMR systems and managing prescription orders with a strong focus on accuracy and detail.

Highest-signal resume keywords

Prior Authorization SubmissionNational Pharmacy Technician CertificationPharmacy Technician LicenseMicrosoft Office ProficiencyAttention to Detail

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Prescription Order ProcessingClaims AdjudicationBenefit VerificationData Entry SkillsMath Skills for Prescription CalculationsPrior Authorization AppealsEMR System ExperienceCoverMyMeds ProficiencyInsurance InquiriesContract Performance Duties

Soft Skills

Excellent Verbal CommunicationExcellent Written CommunicationMultitasking AbilityWorkload ManagementRelationship Building

Certifications & Qualifications

National Pharmacy Technician CertificationState Pharmacy Technician License

Industry Keywords

Prior AuthorizationPharmacy BenefitsFertilityClinical EMR SystemsPrescription Calculations

About the role

Key responsibilities & impact

Research benefits and obtain prior authorizations
Process prescription orders and communicate with sales teams, patients, and providers
Enter prescriptions, adjudicate claims, and resolve claim rejections
Use clinic-specific EMR systems to obtain information for prior authorization submissions
Follow program-specific contractual agreements and company practices
Investigate processing and benefit inquiries from the Fertility Inside Sales team
Perform insurance inquiries and benefit checks
Submit, follow up on, and appeal prior authorizations as needed
Explain pharmacy benefits and answer patient and provider questions
Handle internal and external prior authorization inquiries
Participate in program-specific customer meetings and training sessions
Participate in special projects and perform duties related to contract performance

Requirements

What you’ll need

High School Diploma or GED required
2+ years of Pharmacy Technician experience
Valid National Pharmacy Technician certification required
Valid Arizona, Massachusetts, or Illinois State pharmacy technician license required
Microsoft Office proficiency and data entry skills
Strong math skills related to prescription calculations
Exceptional attention to detail, accuracy, and quality
Excellent verbal and written communication skills
Ability to multitask in both PC/Phone related tasks
1+ year relevant experience with prior authorization submission using CoverMyMeds or similar electronic prior authorization tools
Experience with prior authorization appeals and denials
Experience working with clinical EMR systems and/or infertility is a plus, but not required
Ability to work the specified training and scheduled shifts, including weekends as needed
For home working, cable broadband or fiber optic internet with at least 10 Mbps download/5 Mbps upload
Ability to prioritize and manage workload, meet deadlines, and build strong working relationships

Benefits

Comp & perks

Annual bonus plan eligibility
Medical, vision, and dental benefits starting on day one
Well-being and behavioral health programs
401(k)
Company-paid life insurance
Tuition reimbursement
Minimum of 18 days of paid time off per year
Paid holidays
Leaves of absence