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Express Scripts Prior Authorization Jobs (NOW HIRING)

Cigna

Chief Medical Officer, Evernorth

Bloomfield, CT · On-site

This includes Express Scripts and Evernorth Health Services pharmacy and care delivery businesses ... Clinical Operations Oversight and Prior Authorization Transformation * Partner with internal teams ...

Cigna

Chief Medical Officer, Evernorth

Bloomfield, CT · On-site

This includes Express Scripts and Evernorth Health Services pharmacy and care delivery businesses ... Clinical Operations Oversight and Prior Authorization Transformation * Partner with internal teams ...

Cigna

Chief Medical Officer, Evernorth

Saint Louis, MO · On-site

This includes Express Scripts and Evernorth Health Services pharmacy and care delivery businesses ... Clinical Operations Oversight and Prior Authorization Transformation * Partner with internal teams ...

Cigna

Chief Medical Officer, Evernorth

Franklin, TN · On-site

This includes Express Scripts and Evernorth Health Services pharmacy and care delivery businesses ... Clinical Operations Oversight and Prior Authorization Transformation * Partner with internal teams ...

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How much do express scripts prior authorization jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for express scripts prior authorization in the United States is $43.85, according to ZipRecruiter salary data. Most workers in this role earn between $40.38 and $51.68 per hour, depending on experience, location, and employer.

What is an Express Scripts Prior Authorization?

An Express Scripts Prior Authorization job involves reviewing medication requests to ensure they meet insurance plan requirements before approval. Employees in this role assess prescriptions, follow clinical guidelines, and collaborate with healthcare providers to determine coverage eligibility. The job requires attention to detail, knowledge of pharmacy benefits, and strong communication skills. It helps ensure patients receive the most appropriate and cost-effective medications.

What does an Express Scripts Prior Authorization specialist do?

An Express Scripts Prior Authorization specialist is responsible for reviewing prescription requests, evaluating clinical information, and coordinating with prescribers, patients, and insurance providers to determine coverage eligibility. This role involves managing a high volume of cases, using proprietary systems to document and process authorizations, and frequently communicating via phone and electronic correspondence. Specialists must balance accuracy and efficiency while navigating complex healthcare regulations and helping resolve any issues that arise for patients facing prescription coverage barriers. The position often requires collaboration with pharmacists, physicians, and customer service teams to ensure seamless patient care.

What are the key skills and qualifications needed for an Express Scripts Prior Authorization specialist?

To thrive as an Express Scripts Prior Authorization specialist, you typically need a background in pharmacy or healthcare, knowledge of prescription drug protocols, and experience with insurance processes. Familiarity with pharmacy benefit management (PBM) software, electronic health records (EHRs), and prior authorization platforms is important, as are any relevant pharmacy technician certifications. Strong attention to detail, excellent customer service abilities, and effective communication set top performers apart in this position. These skills ensure accurate and timely authorization processing, minimize errors, and support both patient care and pharmacy operations.

Does Express Scripts Prior Authorization do prior authorization?

Express Scripts Prior Authorization is a process used by healthcare providers and insurance plans to obtain approval for certain medications before they are dispensed. The role of a prior authorization specialist or pharmacist involves reviewing and processing these requests to ensure coverage and compliance with plan policies.

Is express scripts prior authorization a stressful job?

Express Scripts Prior Authorization roles involve reviewing and processing medication requests, which can be demanding due to strict deadlines and the need for accuracy. The job may be stressful during high-volume periods or when handling complex cases, but it also offers a structured environment with clear procedures and the use of specialized software.
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Express Scripts Prior Authorization jobs near you
Infographic showing various Express Scripts Prior Authorization job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $91,208 per year, or $43.9 per hour.

Patient Care Specialist - Data Entry and Prior Authorization

Carepoint Healthcare LLC

Schaumburg, IL • On-site

$20 - $23/hr

Full-time

Re-posted 4 days ago

Job description

Qualifications:

Active Pharmacy Technician License required

Active Pharmacy Technician Certification required (PTCB, ExCPT or Grandfathered)

  1. Experience with ALL Major insurances (PBM)
  2. Aetna
  3. BCBS (Prime)
  4. United healthcare (optum)
  5. Caremark
  6. ESI (express scripts)

Able to read, understand and translate medical charts into the prior authorization format.

Understand Pharmacy Benefits and Deductibles.

Understands diagnosis codes: icd10 codes and how to better utilize them.

Can properly navigate through Cover My Meds to properly fill out forms with medical chart info or Patient medical history.

Able to read and translate Pharmacy scripts.

Must be employed at least 6 months with the organization.


Responsibilities

Calling patients and providers to obtain clinical information needed to complete prior authorization if none provided on script or original fax.

Effectively and efficiently fill out prior authorization forms without missing details.

Following up with insurance for outcomes of the prior authorizations based on submission date and ability to stay on task based on required. completion date.

Need to be detail oriented.

Replying to sales inquiries and inquiries from team members to provide updates or handling customer service calls based on status or doctors’ office calling to update or provide requirements.

Completing prior authorizations within a 14-day time frame or earlier based on supervisors’ expectations.

Must meet perfect attendance and able to rotate through shifts to allow a team member to always be available during hours of operation.