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Express Scripts Prior Authorization Jobs in Tennessee

Vein Guys

Medical Office Manager

Hendersonville, TN · On-site

Advanced knowledge of pre-certification, prior authorization, and medical necessity documentation ... DFWP Opportunities posted here do not create any implied or express employment contract between you ...

Vein Guys

Medical Office Manager

Hendersonville, TN · On-site

Advanced knowledge of pre-certification, prior authorization, and medical necessity documentation ... DFWP Opportunities posted here do not create any implied or express employment contract between you ...

Express

Assistant Manager

Bartlett, TN

About Express Express is a multichannel apparel brand dedicated to a design philosophy rooted in ... Applicants must be currently authorized to work full-time in the United States. PHOENIX does not ...

Express

Assistant Manager

Bartlett, TN · On-site

About Express Express is a multichannel apparel brand dedicated to a design philosophy rooted in ... Prior sales management experience BENEFITS AND COMPENSATION PHOENIX offers a range of benefits to ...

Honorhealth

... scripts and any other pertinent paperwork. * Responsible for adhering to all third party payer ... Obtains prior authorization in order to avoid non-compliance, denials and/or penalties to the ...

Honorhealth

... scripts and any other pertinent paperwork. * Responsible for adhering to all third party payer ... Obtains prior authorization in order to avoid non-compliance, denials and/or penalties to the ...

Honorhealth

... scripts and any other pertinent paperwork. * Responsible for adhering to all third party payer ... Obtains prior authorization in order to avoid non-compliance, denials and/or penalties to the ...

Honorhealth

... scripts and any other pertinent paperwork. * Responsible for adhering to all third party payer ... Obtains prior authorization in order to avoid non-compliance, denials and/or penalties to the ...

Express & Bonobos

Assistant Manager

Bartlett, TN · On-site

About Express Express is a multichannel apparel brand dedicated to a design philosophy rooted in ... Prior sales management experience BENEFITS AND COMPENSATION PHOENIX offers a range of benefits to ...

Tennessee Oncology

Pharmacy Care Tech

Nashville, TN · On-site

$17 - $20.50/hr

Follow procedures and scripts during patient engagement * Decipher single or multiple script needs ... Complete specialty claims processing including but not limited to inclusion of prior authorizations ...

Tennessee Oncology

Pharmacy Care Tech

Nashville, TN · On-site

$17 - $20.50/hr

Follow procedures and scripts during patient engagement * Decipher single or multiple script needs ... Complete specialty claims processing including but not limited to inclusion of prior authorizations ...

Tennessee Oncology

Pharmacy Care Tech

Nashville, TN · On-site

$17 - $20.50/hr

Follow procedures and scripts during patient engagement * Decipher single or multiple script needs ... Complete specialty claims processing including but not limited to inclusion of prior authorizations ...

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Express Scripts Prior Authorization information

What skills are needed for Express Scripts careers?

Candidates for Express Scripts positions typically need strong communication, problem-solving, and customer service skills. Knowledge of healthcare or pharmacy operations, attention to detail, and proficiency with computer systems or pharmacy management software are also important. Certifications such as pharmacy technician licensure may be required for certain roles.

What are the key skills and qualifications needed to thrive in the Express Scripts Prior Authorization position, and why are they important?

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.

What are the main responsibilities of an Express Scripts Prior Authorization specialist on a daily basis?

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 is the lawsuit against Express Scripts?

There have been lawsuits filed against Express Scripts related to allegations of antitrust violations and unfair business practices. These legal actions typically involve claims from competitors or healthcare providers and are handled through the judicial system. Job seekers should stay informed about ongoing legal issues that could impact company operations or reputation.

Does Express Scripts do prior authorization?

Express Scripts, as a pharmacy benefit manager, often requires prior authorization for certain medications to ensure appropriate use and coverage. The process involves healthcare providers submitting documentation for approval before dispensing specific drugs. Job roles related to prior authorization typically involve reviewing medical information and coordinating with healthcare providers to process these requests.

What is an Express Scripts Prior Authorization job?

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 are the typical Express Scripts salaries?

Salaries for roles at Express Scripts vary depending on the position, experience, and location. Entry-level positions such as pharmacy technicians typically earn around $15 to $20 per hour, while more experienced roles like pharmacy managers or data analysts can earn between $60,000 and $100,000 annually. Benefits often include health insurance, retirement plans, and opportunities for professional development.
What are popular job titles related to Express Scripts Prior Authorization jobs in Tennessee? For Express Scripts Prior Authorization jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Express Scripts Prior Authorization jobs in Tennessee look for? The top searched job categories for Express Scripts Prior Authorization jobs in Tennessee are:
Express Scripts Prior Authorization jobs near you

Insurance Verification Specialist (10574)

SOUTHERN SPORTS MEDICINE PARTNERS LLC

Jackson, TN • On-site

$16 - $20/hr

Other

Posted 25 days ago

Job description

SUMMARY:

The Insurance Verification Specialist is responsible for reviewing and processing incoming referrals from external providers to ensure timely access to care, primarily for new patients as well as occasionally for existing patients. This role is critical in initiating the patient care journey, working closely with referring offices, clinical teams, and patients to verify information, obtain past medical records and imaging, and schedule new patient appointments.

KEY RESPONSIBILITIES:

REFERRAL INTAKE & DOCUMENTATION

  • Receive and process inbound referrals from external providers via eFax, EMR, phone, email, or third-party platforms.
  • Review referral documents for completeness and accuracy, including diagnosis, insurance, and provider information.
  • Input referral data into the EMR (e.g., eClinicalWorks), create patient’s chart, and promptly reach out to schedule.
  • Monitor open referrals, making repeated contact attempts to patient over several days via call and text until scheduled.
  • Track reasons referrals are not scheduled within the EMR and provide updates back to referring provider partners.
  • Field incoming calls from referral sources, referred new patients, and self-referrals to coordinate scheduling process.
  • Screen self-referrals (patients who found us online or through word-of-mouth) to understand their condition and past treatment history based on our patient criteria and defined screening scripts prior to scheduling.

PATIENT SUPPORT

  • Contact patients to inform them of appointment details, pre-visit instructions, and next steps.
  • Provide guidance on navigating referred services (e.g., imaging centers, specialists).
  • Address patient questions and coordinate logistics to minimize delays.

COMMUNICATION & COLLABORATION

  • Liaise with external offices and provider groups to ensure seamless referral handoffs.
  • Partner with clinical teams to confirm the accuracy of referral orders and urgency.
  • Escalate any issues or delays to appropriate clinical or administrative staff.

PROFESSIONAL QUALIFICATIONS:

  • High school diploma or equivalent required; associate degree or healthcare training a plus.
  • 1-2 years of experience in a healthcare referral, scheduling, or front office coordination role.
  • Working knowledge of insurance requirements and prior authorization protocols.
  • Strong communication, customer service, and organizational skills.
  • Experience with electronic medical records (eCW preferred).
  • Ability to multitask while maintaining accuracy and attention to detail.

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