Prior Authorization Specialist

Job Description

Job Description

Prior Authorization Specialist

Overview

We are seeking an energetic, detail-oriented professional with a passion for patient care and expertise in navigating the specialty pharmacy ecosystem. The Prior Authorization Specialist will support physician offices in preparing prior authorization requests for both pharmacy and medical benefit submissions. Clear, professional, and efficient communication with prescriber offices is essential to ensure a streamlined process.

This is a fully onsite position, Monday through Friday. Candidates must be available to work on January 1, 2026, without exception . Shift availability will vary, with start times as early as 8 : 00 AM and end times as late as 6 : 00 PM.

Key Responsibilities

Serve as the primary point of contact for prescriber offices regarding the various stages of prior authorization for specialty medications (phone, email, or chat).

Collaborate with insurance plans to complete benefit verification, prior authorization requirements, status updates, and determinations.

Utilize evolving technology platforms to provide efficient, accurate, and up-to-date patient support.

Apply complex problem-solving skills to resolve provider issues, escalating to appropriate internal teams as needed.

Engage with peers in a positive, professional, and solutions-focused manner while adapting to new technologies and processes.

Requirements

Experience : Minimum of 2 years in specialty pharmacy with prior authorization and benefit verification experience.

Skills & Knowledge (Required) :

Strong understanding of drug nomenclature, medical terminology, insurance navigation, and prior authorization processing.

Excellent customer service skills with professional verbal and written communication.

Proficiency in general computer applications and ability to learn new software quickly.

Desired Skills :

Strong attention to detail, organizational abilities, and effective time management.

Core Competencies :

Critical thinking and problem-solving.

Independent, self-managed work style.

Ability to see issues through to full resolution.

Work Requirements

100% onsite presence required.

Availability between 8 : 00 AM - 6 : 00 PM shifts.

Required to work January 1, 2026.

For California Applicants :

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?