Prior Authorization Specialist

About the role

We are seeking a dedicated Pharmacy Technician to join our team, working onsite in Cary, NC. The role involves engaging with patients, manufacturers, and insurance companies, ensuring professional communication at all times. This position offers the opportunity to become a Subject Matter Expert and potential for full-time employment based on performance and availability. This position is based in an office environment with no direct patient contact. The office is closed on major holidays and weekends. This is a rapidly growing specialty pharmacy that values employee engagement and offers a supportive multi‑disciplinary team.

This is a Contract position.

Responsibilities

• Answer inbound calls from patients, manufacturers, and insurance companies.
• Make outbound calls to patients, insurance companies, and manufacturers regarding patient cases.
• Acquire clinical documentation from providers for prior authorization approvals.
• Submit clinical documentation to insurance companies according to their submission requirements.
• Follow up on prior authorization submissions to check for approvals.
• Learn and use the pharmacy management system to process pharmacy claims.
• Adhere to standard operating procedures to maintain accurate records.
• Maintain effective communication with team leaders and colleagues.
• Ensure attention to detail in all tasks.

Requirements

• Critical thinking and problem-solving skills.
• Excellent communication and customer service abilities.
• Prior experience in obtaining prior authorizations is advantageous.
• Ability to work independently with minimal guidance.
• Adaptability to changing assignments.
• Proficiency in Microsoft Teams and Microsoft Outlook.

Qualifications

• Pharmacy technician certification (CPhT).
• Experience in data entry and call center environments.
• Familiar