Prior Authorization
$16.75 - $22.50/hr
The ideal candidate demonstrates strong time management, attention to detail, integrity, and the ... Track and update prior authorization requests and outcomes using internal tracking tools and ...
$16.75 - $22.50/hr
The ideal candidate demonstrates strong time management, attention to detail, integrity, and the ... Track and update prior authorization requests and outcomes using internal tracking tools and ...
$16.75 - $22.50/hr
The ideal candidate demonstrates strong time management, attention to detail, integrity, and the ... Track and update prior authorization requests and outcomes using internal tracking tools and ...
Columbus, OH · On-site
$18.13 - $21.78/hr
The Prior Authorization Specialist handles all prior authorizations, third party appeals, and ... Collaborate with providers to manage appeals and/or peer-to-peer discussion with third party ...
Columbus, OH · On-site
$18.13 - $21.78/hr
The Prior Authorization Specialist handles all prior authorizations, third party appeals, and ... Collaborate with providers to manage appeals and/or peer-to-peer discussion with third party ...
$18.13 - $21.78/hr
The Prior Authorization Specialist handles all prior authorizations, third party appeals, and ... Collaborate with providers to manage appeals and/or peer-to-peer discussion with third party ...
Quick apply
$18.13 - $21.78/hr
The Prior Authorization Specialist handles all prior authorizations, third party appeals, and ... Collaborate with providers to manage appeals and/or peer-to-peer discussion with third party ...
$19 - $23.50/hr
Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. * Submit and Track ...
$19 - $23.50/hr
Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. * Submit and Track ...
Coordinate prior authorization requests with insurance companies. * Use internal technology ... Ability to prioritize and manage time effectively * Knowledge of HIPAA guidelines * Excellent oral ...
Quick apply
Coordinate prior authorization requests with insurance companies. * Use internal technology ... Ability to prioritize and manage time effectively * Knowledge of HIPAA guidelines * Excellent oral ...
$17.75 - $23.50/hr
Work collaboratively with clinicians, practice managers, and other team members to obtain clinical notes and documentation necessary for prior authorization approval. * Verify authorization ...
$17.75 - $23.50/hr
Work collaboratively with clinicians, practice managers, and other team members to obtain clinical notes and documentation necessary for prior authorization approval. * Verify authorization ...
Waltham, MA · On-site +1
$23 - $28/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
Waltham, MA · On-site +1
$23 - $28/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
Houston, TX · On-site +1
$23 - $25/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
Houston, TX · On-site +1
$23 - $25/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
Louisville, KY · Remote
$23 - $25/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
Louisville, KY · Remote
$23 - $25/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
Saint Paul, MN · On-site
This role will focus on the coordination and management of medication and treatment prior authorizations for a mental health organization, ensuring accuracy, timely submission, and alignment with ...
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Saint Paul, MN · On-site
This role will focus on the coordination and management of medication and treatment prior authorizations for a mental health organization, ensuring accuracy, timely submission, and alignment with ...
Brentwood, TN · On-site +1
$17.50 - $21.75/hr
Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. * Submit and Track ...
New
Quick apply
Brentwood, TN · On-site +1
$17.50 - $21.75/hr
Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. * Submit and Track ...
New
New Hyde Park, NY · On-site +1
$23 - $28/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
New Hyde Park, NY · On-site +1
$23 - $28/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
Description Cornerstone Family Healthcare is actively recruiting for a Prior Authorization ... Easily manages multiple authorization requests at once. * Exemplifies excellent customer service ...
Description Cornerstone Family Healthcare is actively recruiting for a Prior Authorization ... Easily manages multiple authorization requests at once. * Exemplifies excellent customer service ...
Middletown, NY · On-site
$21/hr
Job Type Full-time Description Cornerstone Family Healthcare is actively recruiting for a Prior ... Easily manages multiple authorization requests at once. * Exemplifies excellent customer service ...
Middletown, NY · On-site
$21/hr
Job Type Full-time Description Cornerstone Family Healthcare is actively recruiting for a Prior ... Easily manages multiple authorization requests at once. * Exemplifies excellent customer service ...
Middletown, NY · On-site
$21/hr
Description: Cornerstone Family Healthcare is actively recruiting for a Prior Authorization ... Easily manages multiple authorization requests at once. * Exemplifies excellent customer service ...
Middletown, NY · On-site
$21/hr
Description: Cornerstone Family Healthcare is actively recruiting for a Prior Authorization ... Easily manages multiple authorization requests at once. * Exemplifies excellent customer service ...
Washington, DC · On-site
$20.50 - $27.25/hr
Reviews and processes all assigned prior authorization requests to completion. Diligently reviews ... management of all scheduling processes.
Washington, DC · On-site
$20.50 - $27.25/hr
Reviews and processes all assigned prior authorization requests to completion. Diligently reviews ... management of all scheduling processes.
Brea, CA · On-site
$23 - $27/hr
Our company is continuing to grow and we're looking to add a Prior Authorization Specialist to ... At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care ...
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Brea, CA · On-site
$23 - $27/hr
Our company is continuing to grow and we're looking to add a Prior Authorization Specialist to ... At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care ...
$23 - $25/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
$23 - $25/hr
Manage prior authorization requests and appeals with insurance carriers. * Collaborate with physicians, pharmacists, and other departments. * Ensure HIPAA compliance while handling sensitive patient ...
Vadnais Heights, MN · On-site
$25 - $26/hr
This role will focus on the coordination and management of medication and treatment prior authorizations for a mental health organization, ensuring accuracy, timely submission, and alignment with ...
Vadnais Heights, MN · On-site
$25 - $26/hr
This role will focus on the coordination and management of medication and treatment prior authorizations for a mental health organization, ensuring accuracy, timely submission, and alignment with ...
Bowling Green, KY · On-site
$17.75 - $23.50/hr
Work collaboratively with clinicians, practice managers, and other team members to obtain clinical notes and documentation necessary for prior authorization approval. * Verify authorization ...
Bowling Green, KY · On-site
$17.75 - $23.50/hr
Work collaboratively with clinicians, practice managers, and other team members to obtain clinical notes and documentation necessary for prior authorization approval. * Verify authorization ...
$31.5K - $42.3K
9% of jobs
$42.3K - $53K
13% of jobs
$57.3K is the 25th percentile. Wages below this are outliers.
$53K - $63.8K
7% of jobs
$63.8K - $74.6K
17% of jobs
The median wage is $76.8K / yr.
$74.6K - $85.4K
18% of jobs
$85.4K - $96.1K
7% of jobs
$99.6K is the 75th percentile. Wages above this are outliers.
$96.1K - $106.9K
11% of jobs
$106.9K - $117.7K
5% of jobs
$117.7K - $128.5K
5% of jobs
$128.5K - $139.2K
3% of jobs
$139.2K - $150K
4% of jobs
$31.5K
$83.5K
$150K
| Aspect | Manager Cvs Prior Authorization | Pharmacist |
|---|---|---|
| Credentials | Typically requires managerial experience, healthcare administration knowledge, and sometimes a certification in healthcare management | Requires a pharmacy degree (Doctor of Pharmacy) and licensure |
| Work Environment | Office setting, healthcare administration, insurance companies, or pharmacy benefit management | Retail or hospital pharmacy, clinical settings |
| Employer & Industry | Health insurance companies, pharmacy benefit managers, healthcare organizations | Community pharmacies, hospitals, clinics |
| Primary Responsibilities | Overseeing prior authorization processes, managing staff, ensuring compliance | Dispensing medications, patient counseling, verifying prescriptions |
The main difference between a Manager Cvs Prior Authorization and a Pharmacist lies in their roles and credentials. Managers focus on overseeing authorization processes and administrative tasks within healthcare organizations, while pharmacists are licensed professionals responsible for dispensing medications and patient care. Both roles are essential in the healthcare and pharmacy industry but serve distinct functions.

General Summary
The Prior Authorization Specialist coordinates and secures insurance authorization for medications, in-office injections, and imaging when needed to support timely patient care. This role involves reviewing payer requirements, gathering appropriate clinical documentation, and communicating with insurance companies, pharmacies, and internal staff to facilitate authorization approvals. The ideal candidate demonstrates strong time management, attention to detail, integrity, and the ability to manage multiple requests while maintaining organization and professionalism in a high-volume environment.Â
Key ResponsibilitiesÂ
Complete authorization submissions through electronic platforms, payer portals, and telephone communications with insurance representatives when required.Â
Review patient charts to obtain relevant clinical documentation needed to support authorization requestsÂ
Communicate professionally with insurance companies, pharmacies, patients, and internal staff regarding authorization requirements and status updates.Â
Track and update prior authorization requests and outcomes using internal tracking tools and insurance portals to ensure timely processing and follow-up.Â
Demonstrate accountability for assigned authorization requests by monitoring status and following up with payers when necessary. Â
Actively monitor PA Pool and EHR inbox communications to ensure timely response to authorization requests and related inquiries.Â
Ensure all prior authorization submissions and supporting documentation accurately reflect the patient’s medical record and comply with payer requirements.Â
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; stoop, kneel, crouch, or crawl; and talk or hear. The employee must occasionally lift and/or move more than 45 pounds.
Familiarity with medical terminology and working knowledge of medical coding systems (CPT, ICD-10) relevant to prior authorization requests.Â
Strong organizational and time management skills, with the ability to prioritize urgent requests and meet deadlines in a high-volume environment.Â
Excellent written and verbal communication skills when interacting with patients, insurance representatives, pharmacies, and internal clinical staff.Â
Ability to work both independently and collaboratively within a team while managing multiple tasks simultaneously.Â
Demonstrates integrity, professionalism, and ethical decision-making when handling patient information and submitting prior authorization requests.Â
HS Diploma or GEDÂ required.Â
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Outpatient health care
51 - 200 Employees
Birmingham, AL, US
1940