ZipRecruiter

Log In

1

Express Scripts Prior Authorization Jobs (NOW HIRING)

Cigna

Warehouse Associate- Express Scripts

Saint Louis, MO · On-site

$15.50 - $18.50/hr

Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states ...

next page

Showing results 1-20

People also search for

All JobsExpress Scripts Prior Authorization Jobs

Express Scripts Prior Authorization information

See salary details

$11

$43

$54

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

As of Jun 10, 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 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 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.

More about Express Scripts Prior Authorization jobs
What cities are hiring for Express Scripts Prior Authorization jobs? Cities with the most Express Scripts Prior Authorization job openings:
What states have the most Express Scripts Prior Authorization jobs? States with the most job openings for Express Scripts Prior Authorization jobs include:
What job categories do people searching Express Scripts Prior Authorization jobs look for? The top searched job categories for Express Scripts Prior Authorization jobs are:
Express Scripts Prior Authorization jobs near you
Infographic showing various Express Scripts Prior Authorization job openings in the United States as of June 2026, with employment types broken down into 75% Full Time, and 25% Part Time. Highlights an 83% In-person, and 17% Remote job distribution, with an average salary of $91,208 per year, or $43.9 per hour.
Prior Authorization Coordinator, Pharmacy Buisness office, 40hr, Day

Prior Authorization Coordinator, Pharmacy Buisness office, 40hr, Day

UMass Memorial Health

Worcester, MA • On-site, Remote

Full-time

Posted 6 days ago

UMass Memorial Health rating

7.3

Company rating: 7.3 out of 10

Based on 149 frontline employees who took The Breakroom Quiz

295th of 870 rated healthcare providers

Job description

Are you a current UMass Memorial Health caregiver? Apply now through Workday.
Exemption Status:
Non-Exempt
Hiring Range:
$20.94 - $29.27
Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations.
Schedule Details:
Monday through Friday
Scheduled Hours:
830am - 5:00pm, 40hrs/week
Shift:
1 - Day Shift, 8 Hours (United States of America)
Hours:
40
Cost Center:
10020 - 3851 Pharmacy Business Office
Union:
SHARE (State Healthcare and Research Employees)
This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.
Everyone Is a Caregiver
At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.
Obtains authorization numbers from insurance companies, reviews all prior authorization requests for medical necessity, and determines appropriate benefit coverage for all general and oncology infusion clinics supported by the Pharmacy Business office.
Major Responsibilities:
  • Completes prior authorization review for all general and oncology infusions; researching medical necessity in reference to patient diagnosis and treatment plan utilizing appropriate compendiums and insurer policies.
  • Works with multiple insurance carriers/vendors and keeps current with any and all changes as they relate to prior authorization.
  • Communicates / interacts with specific divisions regarding approved or denied prior authorizations. Communicates with Insurance Verification, the Central Billing Office and other Departments in order to resolve prior authorization issues.
  • Manages the "Incoming Patient Report" ensuring appropriate Prior Authorizations are in place.
  • Utilizing appropriate databases, tracking mechanisms, and tools, manages all prior authorization renewals to assure no lapse in medication treatment coverage.
  • Coordinates process for authorization using defined best practices.
  • Participates in the management of a shared database which holds all prior authorization numbers and makes edits as needed.
  • Assists in the maintenance of the Prior Authorization Best Practices manual which includes prior authorization requirement changes made by the insurance carriers and makes recommendations for changes.
  • Performs weekly prior authorization audit to ensure accurate billing and resolves issues that arise.
  • Produces correspondence, reports, memos, etc. as required
  • Sets up and maintains confidential, sensitive files and records for multiple functions, academic materials, medical records, etc. ensuring efficient retrieval of information. Coordinates retrieval of medical records.
  • Ensures adequate inventory of office supplies and basic maintenance of office equipment.
  • Participates in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.
  • Ensures compliance with health and safety requirements and with regulatory agencies such as DPH, etc.

Position Qualifications:
License/Certification/Education:
Required:
  • High School diploma

Experience/Skills:
Required:
  • 2-3 years of medical secretarial/administrative support experience.
  • Microsoft Office and internet skills required.
  • Good customer service skills. Ability to work in a team environment.

Preferred:
  • 6 -12 months of prior authorization experience in an infusion setting preferred.
  • Prior experience using All Scripts, IDX, preferred.

8:30am-5 pm M-F
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.
As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.
If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.

What UMass Memorial Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply