Senior Pharmacy Prior Authorization Representative

The Cigna Group

. Enter prescriptions accurately into the system, adjudicate claims, and work rejections .

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

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in accurately entering prescriptions, managing prior authorizations, and conducting insurance inquiries while adhering to contractual agreements. Proficient in utilizing EMR systems and electronic prior authorization tools to support patient and provider needs effectively.

Highest-signal resume keywords

Pharmacy Technician ExperienceNational Pharmacy Technician CertificationPrior Authorization SubmissionMicrosoft Office ProficiencyAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prescription EntryClaims AdjudicationPrior Authorization AppealsData Entry SkillsMath Skills for Prescription CalculationsEMR Systems ExperiencePrior Authorization Tools ExperienceBenefit ChecksContractual Agreement AdherenceMultitasking Ability

Soft Skills

Excellent Verbal CommunicationExcellent Written CommunicationAbility to Prioritize WorkloadAttention to QualityCustomer Service Orientation

Tools & Technologies

CoverMyMedsElectronic Prior Authorization ToolsClinic-Specific EMR SystemsMicrosoft Office

Certifications & Qualifications

National Pharmacy Technician CertificationState Pharmacy Technician License

Industry Keywords

Pharmacy BenefitsPrior AuthorizationInsurance InquiriesFertility ProgramsClinical EMR Systems

About the role

Key responsibilities & impact

Enter prescriptions accurately into the system, adjudicate claims, and work rejections
Use clinic-specific EMR systems to gather information for prior authorizations
Adhere to program-specific contractual agreements and company practices
Investigate processing and benefit inquiries from the Fertility Inside Sales team
Conduct insurance inquiries and benefit checks
Submit, follow up on, and appeal prior authorizations as needed
Help patients and providers understand pharmacy benefits and answer questions
Handle internal and external prior authorization inquiries
Participate in program-specific customer meetings and training sessions
Participate in special projects and perform other duties related to contract performance
Work with a specialized team supporting specific groups of clinics and high-touch patient programs

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 prioritize and manage workload and meet deadlines
If working at home, cable broadband or fiber optic internet service with at least 10 Mbps download/5 Mbps upload
Ability to work the specified weekday shifts and weekends as needed

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