Prior Authorization Specialist Job at LaSalle Network, Naperville, IL

MFg3VUR4TmRXdVdFd0lRVUlrZ2pCc2JnTVE9PQ==
  • LaSalle Network
  • Naperville, IL

Job Description

We are seeking a dedicated Certified Pharmacy Technician (CPhT) with managed care experience to join our client’s team as a Prior Authorization Specialist . In this role, you will be responsible for managing prescription prior authorization requests, ensuring accurate data entry and assisting with clinical and customer service support. This is a full-time, remote position starting within 10 days of offer acceptance.

Prior Authorization Specialist Responsibilities:
  • Receive, review and provide accurate data entry of prescription prior authorization requests
  • Conduct outreach calls to obtain necessary clinical criteria forms and progress notes
  • Assist with the onboarding of new employer groups and new membership
  • Communicate drug formulary guidelines, prior authorization criteria and plan benefit design to participants, providers and pharmacies
  • Resolve escalated participant issues and claims-related issues
  • Utilize basic Microsoft Excel functions and track metrics
  • Support ongoing clinical programs and assist members with obtaining assistance programs
  • Provide customer service support, including handling member complaints and escalations
Prior Authorization Specialist Requirements:
  • 2+ years of experience as a pharmacy technician
  • Certified Pharmacy Technician (CPhT) License required
  • Prior authorization experience within a pharmacy benefit manager (PBM) setting required
  • Experience with resolving rejected claims and third-party claims adjudication systems
  • Intermediate Microsoft Excel skills preferred
  • Patient, provider, and pharmacy customer service experience preferred
  • Preferred fluency in Spanish
  • Strong communication, analytical and organizational skills
  • Detail-oriented with a focus on providing excellent customer service
  • Ability to interact effectively with patients, providers and coworkers


If you're a qualified Certified Pharmacy Technician with experience in prior authorizations and customer service, and you're excited about this remote opportunity, we encourage you to apply today! We look forward to hearing from you.

Thank you,

Kyla Slayton
Project Manager
LaSalle Network

Job Tags

Remote job, Full time, Contract work, Temporary work,

Similar Jobs

Diamond Oaks Village

Celebrations Coordinator Job at Diamond Oaks Village

 ...newsletter. Provides leadership of lifestyle program. Coordinates the community library. Purchases and maintains equipment and...  ...training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees.... 

Broad River Rehabilitation

Rehab Director Job at Broad River Rehabilitation

Rehab Director / Open to OT/COTA/PT/PTA Candidates! - Gatesville NC / North Carolina - Prior RD experience required! Contact: ****@*****.*** or call Lori at (***) ***-**** for further details! We currently are looking for a dynamic and highly motivated... 

Hirschbach Motor Lines

Orientation Specialist Job at Hirschbach Motor Lines

 ...The Orientation Specialist works with the orientation team and supports our safety personnel to ensure that vehicles are assigned to drivers, that inspections are prepared on incoming and outgoing trucks, that drivers are appropriately trained and road/skill tested, and... 

BCMC

Lab Manager Job at BCMC

 ...characterize of the severity of breaches, develop mitigation plans, and assist with the restoration of services. BCMC is seeking a Lab Manager to support this critical customer mission. Responsibilities: - Applying advanced analytical skills and technical resources... 

Ultimart

Team Lead/Assistant Manager Job at Ultimart

 ...The Team Lead/Assistant Manager is responsible for leading the Ultimart stores day-to-day operations in the absence of the Store Manager, and for otherwise supporting the Store Manager in all aspects of running the store. Summary of Key Responsibilities (include, but...