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Prior Authorization Representative Express Scripts Jobs

Tobii DynaVox

Prior Authorization Submitter

$20/hr

As the world-leader in assistive communication solutions, we empower our customers to express ... JOB SUMMARY: The Prior Authorization Submitter (PAS) works directly with insurance companies to ...

TTI

Customer Service Rep II - Non-Exempt

$16.50 - $22.25/hr

Prior Authorization Representative The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with ...

Hire Talent

Customer Service Rep II - Non-Exempt

$16.50 - $22.25/hr

Prior Authorization Representative The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with ...

Hire Talent

Customer Service Rep II - Non-Exempt

$16.50 - $22.25/hr

Prior Authorization Representative The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with ...

System One Holdings, LLC

Authorization Rep

Tulsa, OK · On-site

$17 - $20/hr

Authorization Rep Location: Tulsa, OK Type: Contract To Hire Compensation: $17-20/hr Work Model ... Obtain prior authorizations and pre-certifications for medical procedures, diagnostic testing ...

Hire Talent

Customer Service Rep II - Non-Exempt

$16.50 - $22.25/hr

Prior Authorization Representative The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with ...

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

As of Jun 29, 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 job?

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 are the typical daily responsibilities of a Prior Authorization Representative at Express Scripts?

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 in the Prior Authorization Representative Express Scripts position, and why are they important?

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
Clinical Services/Prior Authorization Representative

Clinical Services/Prior Authorization Representative

ProCare Rx

Hollywood, FL • On-site

$19/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 15 days ago

Key responsibilities

  • Manage incoming and outgoing calls, documenting all calls in the dedicated application for call documentation.

  • Handle letters from and to pharmacies, physicians, and healthcare providers in support of the Prior Authorization department.

  • Analyze clinical prior authorizations using provided clinical protocols and document recommendations, clinical decisions, and responses in online databases.

Job description

Locations: Miramar, FL
Schedule: Full-Time, Monday – Friday
Pay Rate: $19.00/Hour
ESSENTIAL DUTIES AND RESPONSIBILITIES include but are not limited to the following:
  • Manage incoming and outgoing calls, documenting all calls in the dedicated application for call
    documentation.
  • Handle letters from/to pharmacies, physicians, and healthcare providers in support of the Prior
    Authorization (PA) department.
  • Analyze clinical PAs using the provided clinical protocols, and provide regarding PA requests
    based on provided documentation.
  • Clarify any questions or concerns received from clients and/or internal departments.
  • Assists with inquiries related to pre-authorizations referred by the account managers or other
    departments.
  • Use online databases to document recommendations, clinical decisions, and responses.
  • Deliver high-quality customer service in a fast-paced, dedicated PA program.
  • Provide support on training new employees.
  • Participate in training, conferences, orientations, and other activities related to your business unit.
  • Must have a flexible work schedule to meet changing department needs.
QUALIFICATIONS AND REQUIREMENTS:
  • Pharmacy technician certification (CPhT) required, registered preferred.
  • Prefer 2 years experience working as a pharm tech or as a physician office assistant handling
    phone calls and reviewing charts.
  • 1 year experience contacting other healthcare providers as part of daily job preference.
  • Excellent communication skills working in a professional environment.
  • Strong organizational skills working under time constraints in a constantly changing environment.
  • PC experience to navigate new applications, with intermediate Excel and Word skills preferred.
Physical Demands:
  • This role is primarily sedentary and requires the ability to sit for extended periods (minimum of 7 hours). The position required strong multitasking skills, attentions to detail, and the ability to lift and/o move up to 20 lbs.
The Perks of Joining Our Team:
We believe in taking care of our team. You'll enjoy a comprehensive benefits package designed to support your well-being and financial future:
  • Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.
  • Time to Recharge: Paid vacation and holiday pay.
  • Focus on Your Wellness: We offer a robust Employee Wellness Program.
  • Invest in Your Future: 401(k) with a company match.
  • Support System: Employee Assistance Program provides confidential support and counseling.
  • Get Rewarded for Referring Great People: Employee referral program.

Ready to start your rewarding journey with us? Apply today!
Please note while this job description is a comprehensive overview, additional responsibilities may be part of the role.
ProCare Rx will never ask for a financial commitment from an applicant, as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries, please contact our official recruitment team at HumanResources@procarerx.com.
ProCare Rx is an Equal Opportunity Employer.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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