Prior Authorization Specialist- Healthcare Call Center

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JOB DESCRIPTION

Call Center Rep – Prior Authorization / Pharmacy Tech

Location: Fully Remote
Pay Rate: $20.14/hr W2
Duration: 12 Months
Schedule: Monday–Friday, within 9:00 AM–9:00 PM CST
Training: Approximately 5 weeks, Monday–Friday, 8:00 AM–4:30 PM CST
Safety Sensitive: Yes
Start: Rolling Class Start
Target Class Start: 11/16/2026 and 11/29/2026

Position Summary

The Tech I – Prior Authorization will handle inbound calls from providers, pharmacies, members, and other callers, providing professional and courteous assistance throughout the criteria-based prior authorization process.

The position will maintain complete, timely, and accurate documentation of reviews, approvals, and denials. Clinical questions, escalations, and judgment calls will be transferred to the pharmacist team.

Additional responsibilities may include:

  • Making outbound calls
  • Reviewing and processing Prior Authorizations received via fax and ePA
  • Monitoring and responding to department mailboxes
  • Performing other duties as assigned by leadership

Required / Preferred Qualifications

Candidates must have either:

  • Prior Authorization experience, OR
  • Pharmacy Technician experience/license/knowledge

1. High-Volume Healthcare Call Center Experience

  • Minimum 1 year of inbound call center experience
  • 2+ years preferred
  • Healthcare, insurance, PBM, pharmacy, medical office, or similar environment preferred
  • Strong customer service and verbal/written communication skills
  • Must be comfortable handling a high volume of calls

2. Pharmacy Technician Experience / Knowledge

  • Pharmacy Technician experience strongly preferred
  • At least 1 year of Pharmacy Technician experience in an administrative support function preferred
  • Pharmacy Technician certification preferred but not required
  • Active Pharmacy Technician License, Certification, or Trainee License preferred
  • Familiarity with medical terminology and coding
  • National Pharmacy Technician certification preferred
  • Eligible for state registration, certification, or licensure according to applicable state regulations

If licensed/certified, a screenshot of the active credential must be included at the top of the resume.

3. Computer Multitasking & Documentation Skills

  • Ability to navigate multiple systems while handling calls
  • Advanced computer skills
  • Strong data entry and documentation skills
  • MS Teams and Outlook are required
  • Word and Excel skills are helpful
  • Candidate must complete a free online computer skills assessment and attach the results to the top of the resume

Remote Work Requirements

Candidates must meet all of the following requirements:

  • Fully remote position
  • Hardwired internet connection required; Wi-Fi only is not acceptable
  • Minimum internet speed: 25 Mbps download / 3 Mbps upload
  • Internet speed test screenshot required with submission
  • Private, HIPAA-compliant workspace required
  • Ability to work on a computer for the full duration of the shift
  • Smartphone required for use of the PING application

Education

  • Verifiable High School Diploma or GED required

Top 3 Skills Required

  1. High-Volume Healthcare Call Center Experience
  2. Prior Authorization and/or Pharmacy Technician Experience
  3. Computer Multitasking, Documentation & MS Teams/Outlook

Work Arrangement: Fully Remote — never required to work onsite.

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1. HOW DO YOU PLAN YOUR DAY?

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