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 10/15/2026full-timeRemote • United StatesSeniorWebsite

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
Interface with other departments and identify medical documentation supporting prior authorization requests
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 timely
Relay problems, concerns, questions, and ideas through appropriate communication lines
Maintain expected productivity and work effectively
Meet quality standards and demonstrate reliability and follow-through
Communicate effectively and express ideas clearly
Perform in accordance with system-wide competencies and behaviors
Perform other duties as assigned

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)
If working at home occasionally or permanently, internet connection through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload

Benefits

Comp & perks

Remote work arrangement
Work-from-home internet service requirement with minimum speeds of 10Mbps download/5Mbps upload
Tobacco-free policy and smoking cessation program eligibility where applicable