Prime Therapeutics
Prior Authorization Analyst Sr (Remote)
This job is now closed
Job Description
- Req#: R-16009
Employer Industry: Pharmacy Benefit Management
Why consider this job opportunity:
- Salary up to $138,000.00 based on experience and skills
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to develop advanced subject matter expertise in pharmacy claims processing
- Potential for remote work flexibility
- Commitment to diversity and equal opportunity employment
What to Expect (Job Responsibilities):
- Serve as a functional subject matter expert for prior authorization input, maintenance, and issue resolution in the pharmacy claim adjudication system
- Collaborate with internal partners to clarify request intent and desired outcomes for prior authorizations
- Ensure quality maintenance and implementation of prior authorization loads through thorough analysis and validation
- Resolve complex assignments received by the team and assist in mentoring Analyst-level colleagues
- Identify new efficiencies and enhance current processes as needed
What is Required (Qualifications):
- Bachelor's degree in Business Administration or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED required
- Minimum of 5 years of benefits, claims, or PBM operations experience
- Must be eligible to work in the United States without the need for a work visa or residency sponsorship
- Strong analytical and problem-solving skills with attention to detail
- Excellent verbal and written communication skills
How to Stand Out (Preferred Qualifications):
- Previous experience with Medicare or Medicaid
- Experience performing data analysis and validation
- Strong desire to be a subject matter expert
- Experience working on cross-functional projects
- High proficiency in RxClaim, Microsoft Office Products (Word, Excel, Outlook), and Clinical Review Engine (CRE)
#PharmacyBenefitManagement #CareerOpportunity #RemoteWork #DiversityAndInclusion #CompetitiveSalary
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