Prior Authorization Specialist - 246181Medix • Pittsburgh, PA, US
Prior Authorization Specialist - 246181
Medix • Pittsburgh, PA, US
17 days ago
Job type
- Full-time
Job descriptionCommunicate with prescriber offices to facilitate all steps of the PA process (via phone, chat, and email) Use various technology platforms to gather, submit, and track prior authorization cases Conduct benefit verification and navigate insurance requirements for both pharmacy and medical benefits Assemble complete case files using clinical documentation like chart notes, lab results, and medication histories Troubleshoot and follow up with payers until a final determination is reached Collaborate with internal teams to ensure process efficiency and patient-first outcomes Minimum 2 years of specialty pharmacy experience with a focus on prior authorization and benefit verification Strong understanding of drug names, medical terminology, and insurance workflows Excellent verbal and written communication and customer service skills Comfortable using evolving technologies and general computer proficiency Highly organized and detail-oriented Strong time management and prioritization abilities Critical thinking and independent problem-solving skills Able to work independently while contributing positively to a collaborative team environment Investigate : Start each case with a detailed benefit verification to identify insurance requirements Communicate & Gather : Reach out to providers to collect necessary documentation Assemble & Submit : Compile "clean" cases and submit through payer portals Follow-Up & Troubleshoot : Proactively track submissions and resolve issues until final determination Help real patients get the treatments they need Be part of a mission-driven, solutions-focused team Work in a vibrant part of Pittsburgh's Strip District Stable full-time hours with a competitive hourly wage
We are seeking an energetic, detail-oriented Prior Authorization Specialist to join our team and play a key role in helping patients access life-changing specialty medications. If you're passionate about patient care and experienced in the specialty pharmacy ecosystem, we want to hear from you!
This role is 100% onsite and focused on supporting healthcare providers through the prior authorization (PA) process - from benefit verification to successful submission and follow-up.
- Job Opening : Prior Authorization Specialist
- Location : Onsite - Strip District, Pittsburgh, PA
- Pay : $22 / hour
- Schedule : Monday - Friday, 40 hours / week
- Start Date Requirement : Must be available to work on January 1, 2026 (no exceptions). Ideally looking for someone on the sooner side.
- Shift Flexibility : Between 8 : 00 AM and 6 : 00 PM (standard 8-hour shift within this window)
Key Responsibilities :
Required Background & Experience :
Preferred Skills & Competencies :
What You'll Be Doing (Day-to-Day) :
Think of this role as being the engine of the authorization process. You'll be the go-to expert who quarterbacks each case from start to finish :
Why Join Us?
Ready to Apply?
If you're experienced, motivated, and ready to make a difference in patient care, we'd love to hear from you. Apply today!
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Prior Authorization Specialist • Pittsburgh, PA, US
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