Remote Prior Authorization Rn Jobs in Frisco, TX

Prior Authorization Pharmacy Case Manager Pay: $20.00/hour Job Type: Full-Time | Remote | 40 Hours per Week Are you passionate about helping patients navigate the healthcare system? We are seeking experienced Case Managers to support patients through the medication access process, ensuring they receive the therapies they need. This is an excellent opportunity for professionals with experience in patient access, benefit verification, prior authorizations, specialty pharmacy, or healthcare reimbursement. Prior Authorization Pharmacy Case Manager Compensation $20.00 per hour Full-time, 40 hours per week Remote position with company-provided equipment What You'll Do As a Case Manager, you will manage patient cases from initial enrollment through medication access and delivery while providing exceptional customer service. Prior Authorization Pharmacy Case Manager Responsibilities include: Manage patient cases from benefit investigation through medication delivery. Complete benefit verifications for commercial insurance, Medicare, and Medicaid plans Coordinate with physician offices, specialty pharmacies, insurance carriers, and patients. Process prior authorizations and assist with appeals when necessary. Educate patients on insurance coverage, out-of-pocket costs, and available assistance programs. Handle inbound and outbound calls to resolve patient questions and case updates. Process enrollments received via phone, fax, and electronic submissions. Review documentation for accuracy and obtain missing information as needed. Maintain detailed documentation within internal systems. Prioritize cases to ensure timely patient access to therapy. Prior Authorization Pharmacy Case Manager Qualifications Prior Authorization Pharmacy Case Manager Required: 2+ years of experience in patient access, healthcare case management, benefit verification, specialty pharmacy, or a related healthcare support role Strong customer service and communication skills Excellent computer and data entry skills Ability to work independently in a fast-paced environment. High School Diploma or equivalent Prior Authorization Pharmacy Case Manager Preferred: Previous Hub Services or Patient Support Program experience Experience with benefit investigations, insurance verification, prior authorizations, and appeals Knowledge of Medicare, Medicaid, and commercial insurance plans Understanding of specialty medications and medication adherence Prior Authorization Pharmacy Case Manager Training & Schedule Mandatory Paid Training: October 5 – November 6 Training Hours: Monday-Friday, 8:00 AM – 5:00 PM Central Time Go Live Date: November 9 After training, employees must be available to work assigned shifts between: Monday-Friday 7:00 AM – 8:00 PM Central Time Prior Authorization Pharmacy Case Manager Performance Expectations Complete approximately 2-3 patient cases per hour Make an average of 10 outbound calls per day. Manage patient follow-up activities including: Proof of income requests Refill coordination Benefit follow-up General case management and triage Prior Authorization Pharmacy Case Manager Remote Work Requirements This is a fully remote position. Employees must have: A dedicated, quiet workspace free from distractions High-speed wired internet connection (DSL, Cable, or Fiber) Minimum download speed of 15 Mbps Minimum upload speed of 5 Mbps Hardwired Ethernet connection (Wi-Fi, satellite, and cellular internet are not permitted) Surge protector with network line protection. Company-issued computer and equipment will be provided. Prior Authorization Pharmacy Case Manager Ideal Background Candidates with experience in any of the following roles are encouraged to apply: Case Manager Patient Access Specialist Benefits Investigation Specialist Prior Authorization Specialist Hub Services Coordinator Pharmacy Case Manager Reimbursement Specialist Specialty Pharmacy Representative Schedule: Full-Time | Monday-Friday | Flexible shifts between 7:00 AM-8:00 PM Central Time Please note: Resumes should clearly demonstrate experience with benefit verification, insurance investigations, prior authorizations, patient access, specialty pharmacy, or similar case management responsibilities.