Prior authorization processing jobs

Personal Care Specialist

Cencora · Posted Nov 9, 2026

Open

Remote, Canada
Remote
Full-time
3+ years

Apply with Referso

Personal Care Specialist

Cencora · Posted Nov 9, 2026

Open

Remote, Canada
Remote
Full-time
3+ years

Apply with Referso

Personal Care Specialist

Cencora · Posted Nov 9, 2026

Open

Remote, Canada
Remote
Full-time · Associate
3+ years

Apply with RefersoAI Apply on careers page

Supports documentation compliance, processes prior authorization requests, verifies insurance coverage, and coordinates specialty pharmacy referrals.

Responsibilities

Supports documentation compliance by recording patient interactions, updating case notes in pharmacy systems, and maintaining privacy requirements.
Processes prior authorization requests by collecting clinical documentation, completing payer-specific forms using templates, submitting requests, and tracking status.
Verifies insurance coverage by reviewing patient insurance cards, checking formulary information, and documenting coverage details.
Supports financial assistance enrollment by collecting patient eligibility information, completing manufacturer copay applications, and submitting paperwork to program administrators.
Coordinates specialty pharmacy referrals by processing forms, verifying insurance benefits, scheduling patient calls, and liaising with specialty pharmacy teams.

Requirements

High School Diploma/GED or equivalent
Associate's degree in healthcare administration, life sciences, pharmacy technology, or a related field

Skills

pharmacy support prior authorization processing

Pharmacy Specialist I

Horizon Blue Cross Blue Shield of New Jersey · Posted Nov 6, 2026

Open

Hopewell, New Jersey, United States
Hybrid
Full-time · Associate
$45K–$60K per year
2+ years

Apply with RefersoAI Apply on careers page

Responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or members, supporting and assisting in the coordination of Pharmacy Services benefits.

Compensation

$44,600 - $59,745

Responsibilities

Process prior authorization requests via fax or help line by evaluating medical necessity/appropriateness
Conduct telephonic interaction with members, physician office staff, pharmacies and internal stakeholders for eligibility, coverage determination, and/or claim issues
Engage with physicians & pharmacists to conduct effective interventions through clinical therapeutic interchange
Capture accurate and comprehensive clinical information for Prior Authorization requests
Process complaints, appeals, grievances, executive inquiries and compliance related issues

Requirements

High School Diploma/GED
Nice to have: Third party prescription program claim adjudication experience

Skills

Prior authorization processing Claim adjudication Managed care principles Medical terminology knowledge

Pharmacy Technician II – Clinical Pharmacy Care Center

Elevance Health · Posted Nov 6, 2026

Open

Remote, United States
Remote
2+ years

Apply with RefersoAI Apply on careers page

Pharmacy Technician II – Clinical Pharmacy Care Center

Responsibilities

Verifies member information and inputs data for pharmacists
Educates members on pharmacy rules and medication resources
Processes prior authorization requests and ensures Medicare compliance
Provides resolution to grievances and appeals
Responds to inquiries from physicians, sales team, and members

Requirements

High School Diploma or equivalent
Nice to have: Communicating with Medicare members
Nice to have: Call center experience with high call volumes
Nice to have: Discussing medication adherence
Nice to have: Patient care experience

Skills

Pharmacy technician license Interpretation and data entry of prescriptions Prior authorization processing Troubleshooting adjudication issues Computer systems proficiency

Pharmacy Intern

Elevance Health · Posted Nov 6, 2026

Open

Richmond, Virginia, United States
Hybrid
Internship · Intern
$16–$32 per hour

Apply with RefersoAI Apply on careers page

Interpret and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues.

Compensation

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $16.34 to $31.94

Responsibilities

Assists in developing and configuring prior authorization decision trees in the workflow tool
Participates in quality assurance feedback from pharmacists of prior authorization decision trees within the workflow tool
Assists in implementing clinical programs within the prior authorization space
Verifies member, provider, and drug information and inputs data for the prior authorization pharmacists
Educates providers on pharmacy-based rules related to prescriptions and medication resources or assistance programs

Requirements

Pharmacy program at an accredited college or university
Nice to have: 1st and 2nd year PharmD students
Nice to have: prior experience working in pharmacy retail

Skills

prior authorization processing data entry Microsoft Office

Pharmacy Technician II

Elevance Health · Posted Nov 6, 2026

Open

Atlanta, Georgia, United States
Hybrid
Full-time · Mid
2+ years

Apply with RefersoAI Apply on careers page

Responsible for interpreting and entering moderately complex prescriptions, processing prior authorizations, and troubleshooting adjudication issues for a pharmacy within a virtual hybrid environment.

Responsibilities

Verifies member information and inputs data for pharmacists
Educates members on pharmacy rules and medication resources
Processes prior authorization requests and ensures Medicare compliance
Provides resolution to grievances and appeals
Responds to inquiries from physicians, sales team, and members

Requirements

High School diploma or equivalent
Nice to have: Call Center Experience
Nice to have: PTCB Certification

Skills

Pharmacy Technician Prior Authorization Processing Data Entry Medication Resources Adjudication Troubleshooting

Benefits

Merit increases
Paid holidays