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Prior Authorization Representative Express Scripts Jobs

Arizona Priority Care

Prior Authorization Rep

Chandler, AZ · Hybrid

$39K - $54K/yr

The Prior Authorization Representative I is responsible for processing incoming requests including verifying eligibility and benefits and the data entry component of the prior authorization request.

Avera Health

Prior Authorization Representative

Le Mars, IA · On-site

$16 - $19.25/hr

Floyd Valley Healthcare in Le Mars, IA has a full-time Centralized Authorization Representative ... Appropriately document prior authorization and communicate information to performing facility ...

Avera Health

Prior Authorization Representative

Le Mars, IA · On-site

$16 - $19.25/hr

Floyd Valley Healthcare in Le Mars, IA has a full-time Centralized Authorization Representative ... Appropriately document prior authorization and communicate information to performing facility ...

Avera Health

Prior Authorization Representative

Le Mars, IA · On-site

$16 - $19.25/hr

Floyd Valley Healthcare in Le Mars, IA has a full-time Centralized Authorization Representative ... Appropriately document prior authorization and communicate information to performing facility ...

BJC HealthCare

Prior Authorization Rep

Saint Louis, MO · Hybrid

$15.50 - $19.75/hr

EPIC, Insurance background, and Prior Authorization experience Overview Preferred Qualifications ... The role represent BJC with the highest standard of customer service, compassion and perform all ...

HaysMed

Prior Authorization Representative

Hays, KS · On-site

$15.75 - $20/hr

A Hospital Prior Authorization Representative assesses patient medical records, prepares and submits authorization requests, and liaises with insurance companies to resolve issues. They also inform ...

BJC

Prior Authorization Rep

Saint Louis, MO · On-site

$16.50 - $21.25/hr

Prefer experience: EPIC, Insurance background, and Prior Authorization experience Overview ... The role represent BJC with the highest standard of customer service, compassion and perform all ...

Managed Staffing

Prior Authorization Representative

AL · Remote

$17.50 - $18.50/hr

Prior Authorization Technician Location: Fully Remote (Work from Home - Anywhere in the U.S.) Pay Rate: $17.90/hour (W2) Schedule: Monday-Friday, 8-hour shifts between 8:00 AM-8:00 PM CT Training ...

BJC HealthCare

Prior Authorization Rep

Saint Louis, MO · On-site

$17.75 - $25.56/hr

Prefer experience: EPIC, Insurance background, and Prior Authorization experience Overview ... The role represent BJC with the highest standard of customer service, compassion and perform all ...

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Prior Authorization Representative Express Scripts information

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

As of Aug 11, 2026, the average hourly pay for prior authorization representative express scripts in the United States is $18.05, according to ZipRecruiter salary data. Most workers in this role earn between $14.90 and $19.23 per hour, depending on experience, location, and employer.

What is a prior authorization representative Express Scripts?

A Prior Authorization Representative at Express Scripts is responsible for reviewing and processing medication prior authorization requests from healthcare providers and pharmacies. They assess requests based on insurance coverage policies, ensuring prescriptions meet clinical and formulary guidelines. The representative communicates approval or denial decisions and may collaborate with prescribers for additional information. Strong attention to detail, customer service skills, and knowledge of medical terminology are essential for success in this role.

What does a prior authorization representative Express Scripts do?

In this role, you will review and process prior authorization requests for prescription medications, ensuring that all necessary documentation and criteria are met. You’ll communicate frequently with healthcare providers, patients, and insurance companies to gather information, explain coverage decisions, and resolve any issues. Coordination with pharmacy teams and use of specialized software are also routine responsibilities. The position requires strong organizational skills and adaptability, as you will often manage multiple cases with varying priorities throughout your day.

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

To excel as a Prior Authorization Representative at Express Scripts, you need strong knowledge of pharmacy benefits, medical terminology, and insurance processes, often supported by experience in healthcare or pharmacy settings. Familiarity with prior authorization systems, insurance verification tools, and HIPAA compliance is important, and some employers may prefer a pharmacy technician certification. Exceptional communication, attention to detail, and problem-solving skills help representatives navigate patient and provider inquiries efficiently. These qualifications ensure timely and accurate processing of medication requests, helping patients access care while maintaining regulatory and company standards.

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Prior Authorization Representative Express Scripts jobs near you
Infographic showing various Prior Authorization Representative Express Scripts 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 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $37,548 per year, or $18.1 per hour.

Prior Authorization Representative

Clinical Associates, P.A.

Towson, MD

$38K - $52K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 15 hours ago

Job description

Description

Prior Authorization Representative


At Clinical Associates, we make being healthy easier. As a premier multi-specialty physicians' practice located in the Towson, Pikesville, and Reisterstown communities, we connect our patients to a seamless system of integrated medical care. Our practice includes in-house specialists in areas of medicine, from cardiology to podiatry. We also offer unique services like our nuclear stress testing facility.


We are seeking to add an experienced and detail-oriented Prior Authorization Representative to our Cardiology team! Our ideal candidate will possess 1-2 years of experience in a healthcare setting with solid working knowledge of insurance verification & eligibility along with obtaining prior authorizations for office procedures and diagnostic testing. The candidate must be a team player and provide excellent customer service to our patients.


Shift Hours: Full Time / Monday - Friday 8:30 am - 4:30 pm

Location: Towson - 515 Fairmount Avenue or Pikesville - 1838 Greene Tree Road


**This is an in-person onsite position. No hybrid or remote work options are available.**


Job Duties include but are not limited to the following:

  • Runs appointment lists and verifies insurance coverage along with identifying which patients need prior authorizations for scheduled appointments, procedures, and diagnostic testing.
  • Completes the prior authorization process 2 weeks prior to the scheduled appointments.
  • Contacts patients to inform them of their financial out-of-pocket costs: co-pay, deductible, and co-insurance amounts.
  • Confirms if referrals have been received prior to scheduled appointments.
  • Contacts primary care providers or other healthcare facilities as needed to obtain referrals or missing information for office visits or procedures.
  • Contacts insurance companies to confirm continued coverage or to resolve billing issues, discrepancies, or denials.
  • Accurately enters and updates patient demographics, insurance information, and authorization and referral tracking into the EMR system.
  • Schedules appointments
  • Other duties as assigned to support the overall workflow efficiency of the department.

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MINIMUM QUALIFICATIONS:

  • High School Diploma or equivalent
  • Medical office or health care experience is required. Specialty medicine and/or Cardiology are a plus.
  • 1-2 years of proven experience in healthcare insurance verification / prior authorization or billing is required.
  • Strong attention to detail and organizational skills.
  • Strong time management skills.
  • Knowledge and understanding of CPT/ICD 10 coding and billing protocols.
  • Experience with EPM/EMR - specifically NextGen is a plus.
  • Excellent verbal communication skills with ability to hear and to speak standard English clearly and concisely.
  • Excellent written communication skills with ability to read, write and spell standard English clearly and concisely.
  • Ability to interact effectively with culturally diverse patients, practitioners, and employee population.
  • Ability to convey a positive attitude and project a professional image.
  • Ability to remain flexible and maintain confidentiality.
  • Possesses excellent time management skills.
  • Requires lengthy periods of sitting, intermittent standing, reaching, and bending.

Benefits:

  • Paid Time Off
  • Medical
  • Vision
  • Dental
  • Life Insurance
  • Paid Holidays
  • 401K(matching)

Clinical Associates is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

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