Senior Pharmacy Prior Authorization Representative

The Cigna Group

. Obtain initial and renewal authorizations for Specialty Pharmacy and/or Specialty Infusion services from insurance companies via portal, phone, and fax .

Posted 10/16/2026full-timeRemote • Florida • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in obtaining authorizations for Specialty Pharmacy and Specialty Infusion services, with a strong understanding of medical terminology, payer websites, and authorization requirements. Proficient in managing tasks efficiently while maintaining high productivity and quality standards.

Highest-signal resume keywords

Prior Authorization ExperienceInsurance VerificationKnowledge Of Medical TerminologyProficient Computer SkillsOrganizational Skills

ATS Keywords

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Applicant Tracking System Keywords

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

Hard Skills

Prior AuthorizationInsurance VerificationMedical TerminologyPlan Formularies KnowledgeAuthorization Requirements Knowledge

Soft Skills

Attention To DetailMultitaskingVerbal CommunicationWritten Communication

Tools & Technologies

Microsoft Office ProductsWindowsMS Office SuiteOutlookWordExcel

Certifications & Qualifications

HS DiplomaGED

Industry Keywords

Payer WebsitesEligibilityCoordination Of BenefitsPharmacy PayersMedical Payers

About the role

Key responsibilities & impact

Obtain initial and renewal authorizations for Specialty Pharmacy and/or Specialty Infusion services from insurance companies via portal, phone, and fax
Follow up on initial and renewal authorizations in a timely manner
Collaborate with clinicians and other departments to identify supporting medical documentation
Notify patients, prescribers, and internal teams of insurance denials and appeals processes
Confirm plan eligibility and process test claims
Calculate required units and quantity versus day supply
Prioritize and complete assigned tasks on schedule
Respond to chat and email update requests promptly
Communicate problems, concerns, questions, and ideas through appropriate channels
Maintain expected productivity and quality standards
Perform other assigned duties

Requirements

What you’ll need

HS diploma or GED required
2+ years of prior authorization, insurance verification or other related experience in a physician practice, ancillary provider, or other relevant healthcare setting required
Knowledge of medical terminology required
Knowledge of payer websites, eligibility, and coordination of benefits required
Knowledge of plan formularies and authorization requirements required
Knowledge of pharmacy vs medical payers and authorization required
Proficient computer skills and Microsoft Office Products required
Computer literacy, including Windows and MS Office Suite (Outlook, Word, and Excel)
Good organizational skills with attention to detail and ability to multitask
Good verbal and written communication skills
Ability to maintain confidentiality of patient information
Internet connection through cable broadband or fiber optic service with at least 10Mbps download/5Mbps upload when working from home

Benefits

Comp & perks

Remote work option (occasionally or permanently)
Cable broadband or fiber optic internet requirement for home working, with at least 10Mbps download/5Mbps upload
Tobacco-free policy
Reasonable accommodation support for the online application process