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Overnight Prior Authorization Representative Express Scripts Jobs in Alabama

Huntsville Hospital Health System

Pre Cert Rep

Madison, AL

$15.25 - $19.50/hr

Overview The Pre-Certification Representative is responsible for obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization. All job ...

Huntsville Hospital Health System

Pre Cert Rep

Madison, AL · On-site

$15.25 - $19.50/hr

Overview The Pre-Certification Representative is responsible for obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization. All job ...

Huntsville Hospital Health System

Pre Cert Rep

Madison, AL · On-site

$15.25 - $19.50/hr

The Pre-Certification Representative is responsible for obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization. All job functions are ...

Cencora

For this position, expertise in pharmacy benefit reimbursement, prior authorizations, appeals, and ... This role requires weekly travel, including potential overnight stays, to healthcare offices within ...

Crinetics Pharmaceuticals

$19.50 - $26.75/hr

... prior authorizations, resubmissions, and denials. Candidates are strongly preferred to reside ... The physical demands described above are representative of those that must be met by an employee to ...

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Overnight Prior Authorization Representative Express Scripts information

What is an overnight prior authorization representative at Express Scripts?

An Overnight Prior Authorization Representative at Express Scripts is responsible for processing and evaluating prescription medication requests that require authorization from insurance providers, primarily during overnight shifts. This role involves reviewing clinical information, communicating with healthcare providers, and ensuring that medications meet insurance guidelines for approval. Representatives also provide customer service to patients, doctors, and pharmacists, helping to resolve issues and explain the prior authorization process. Working overnight means handling requests that come in outside of typical business hours, ensuring 24/7 support for patients and providers.

What are the key skills and qualifications needed to thrive as an overnight prior authorization representative at Express Scripts?

To thrive as an Overnight Prior Authorization Representative at Express Scripts, you need a solid understanding of pharmacy benefits, medical terminology, and prior authorization processes, often supported by a high school diploma or equivalent and relevant experience in healthcare or pharmacy. Familiarity with pharmacy management software, claims processing systems, and Microsoft Office Suite is typically required. Attention to detail, strong problem-solving skills, and effective communication are critical soft skills for success in this position. These competencies ensure accurate and timely authorization decisions, safeguard patient access to medications, and uphold compliance with regulatory standards during overnight shifts.

What are some common challenges faced by overnight prior authorization representatives at Express Scripts, and how can they be managed?

Overnight Prior Authorization Representatives at Express Scripts often face challenges such as managing high call volumes during off-peak hours, handling urgent medication requests, and working independently with limited on-site supervision. To manage these challenges, representatives should develop strong organizational skills, remain updated on the latest formulary guidelines, and leverage internal resources or escalation protocols for complex cases. Building effective communication with pharmacists, physicians, and other team members—even during overnight shifts—can also help ensure smooth case resolution and maintain high service quality.

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For Overnight Prior Authorization Representative Express Scripts jobs in Alabama, the most frequently searched job titles are:

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Overnight Prior Authorization Representative Express Scripts jobs near you
Infographic showing various Overnight Prior Authorization Representative Express Scripts job openings in Alabama as of June 2026, with employment types broken down into 57% Full Time, 39% Part Time, and 4% Temporary. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.

Prior Authorization

Urology Centers of Alabama, P.C.

Birmingham, AL • On-site

$16.75 - $22.50/hr

Other

Posted 12 days ago

Job description

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.
Key Responsibilities
  • Complete authorization submissions through electronic platforms, payer portals, and telephone communications with insurance representatives when required.
  • Review patient charts to obtain relevant clinical documentation needed to support authorization requests
  • Communicate professionally with insurance companies, pharmacies, patients, and internal staff regarding authorization requirements and status updates.
  • Track and update prior authorization requests and outcomes using internal tracking tools and insurance portals to ensure timely processing and follow-up.
  • Demonstrate accountability for assigned authorization requests by monitoring status and following up with payers when necessary.
  • Actively monitor PA Pool and EHR inbox communications to ensure timely response to authorization requests and related inquiries.
  • Ensure all prior authorization submissions and supporting documentation accurately reflect the patient's medical record and comply with payer requirements.

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.
  • Strong organizational and time management skills, with the ability to prioritize urgent requests and meet deadlines in a high-volume environment.
  • Excellent written and verbal communication skills when interacting with patients, insurance representatives, pharmacies, and internal clinical staff.
  • Ability to work both independently and collaboratively within a team while managing multiple tasks simultaneously.
  • Demonstrates integrity, professionalism, and ethical decision-making when handling patient information and submitting prior authorization requests.
  • HS Diploma or GED required.

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