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Prior Authorization Representative Express Scripts Jobs in Florida

SMI IMAGING LLC

Pre-Authorization Representative

Orlando, FL · On-site

$37K - $51K/yr

Obtains pre-certification and registration prior to a patient's appointment. * Gathers pertinent ... Provides ongoing communication with patient regarding authorization and scheduling process. * Has ...

Future Electronics

Sales Support Representative

Orlando, FL · On-site

$17.75 - $24.25/hr

About the role The primary role of the Sale Support Representative will be to assist the Sales ... Prescription coverage through Express Scripts * Two dental plan options with Delta Dental of MA

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Prior Authorization Representative Express Scripts information

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.

What are the most commonly searched types of Prior Authorization Representative Express Scripts jobs in Florida?

The most popular types of Prior Authorization Representative Express Scripts jobs in Florida are:

What are popular job titles related to Prior Authorization Representative Express Scripts jobs in Florida?

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

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The top searched job categories for Prior Authorization Representative Express Scripts jobs in Florida are:

Prior Authorization Representative Express Scripts jobs near you
Infographic showing various Prior Authorization Representative Express Scripts job openings in Florida as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Pre-Authorization Representative

SMI IMAGING LLC

Orlando, FL • On-site

$37K - $51K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 25 days ago

Job description

Description
Join the fastest growing outpatient radiology practice in the Nation- SimonMed Imaging! Our commitment to excellence and improving patient care paired with the best in class technology allows us to be an industry leader in the constantly evolving health care environment. Secure your spot now and take advantage of a unique career opportunity to advance your skills while working alongside a dedicated team of board-certified subspecialty radiologists. We can't wait to meet you!
ESSENTIAL FUNCTIONS:
  • Demonstrates competency in the performance of job related skills appropriate to his/her customer populations and departmental services.
  • Ensures patients have been cleared for specific diagnostic tests.
  • Obtains pre-certification and registration prior to a patient's appointment.
  • Gathers pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided.
  • Provides ongoing communication with patient regarding authorization and scheduling process.
  • Has knowledge insurances and of commonly-used concepts, practices, and procedures.
  • Relies on instructions and pre-established guidelines to perform the functions of the job.

OTHER DUTIES: Please note this job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time or without notice.
BENEFITS: Your health, happiness and future matters! At SimonMed Imaging, we offer medical, vision and dental insurance, significant Imaging discounts, 401(k) eligibility, paid holidays plus PTO, Sick Time, opportunity for growth, and much more!
MINIMUM QUALIFICATIONS:
A high school diploma or equivalent, and 2-4 years of experience in a relevant position.
PHYSICAL DEMANDS: This position may require duties including lifting and carrying up to 40 pounds, sitting for prolonged periods of time, with frequent standing and walking.
DRESS ATTIRE: Business Casual or scrubs dependent on department
We are 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. Employment is contingent upon successful completion of drug and background screening. Some positions will require a favorable driving record.
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