PSC, Medication Prior Authorization and Pharmacy

Who We Are

At Panorama Eyecare, we are not just a team; we are a community of dedicated professionals united in our quest to provide the best eyecare anywhere. Our unflinching commitment to excellence and our core values are what make us an Employer of Choice. Join us in shaping the future of eyecare as we thrive together!

The Position

The Medication Prior Authorization and Pharmacy Patient Service Coordinator (PSC) is a remote role responsible for obtaining, tracking, and managing prior authorizations related to medications only, including prescription approvals, refills, and pharmacy coordination. This position works closely with clinical teams, pharmacies, insurance payers, and patients to ensure timely access to medications and to minimize delays in treatment.

This position plays a critical role in patient access, medication adherence, revenue integrity, and overall care coordination by supporting authorization workflows, patient assistance programs, and pharmacy communication.

Responsibilities

Medication Prior Authorizations

• Submit and manage prior authorization requests for medications only, as required by insurance carriers.
• Review physician medication orders, supporting clinical notes, and documentation to ensure prior authorization requests are complete and accurate.
• Track medication prior authorizations from submission through approval, denial, or request for additional information.
• Follow up with payers to ensure timely determinations and minimize delays in medication access.

Medication Refills & Pharmacy Coordination

• Coordinate prescription refills in collaboration with providers and pharmacies.
• Serve as the primary point of contact for pharmacies regarding medication-related questions, clarifications, and insurance requirements.
• Communicate with pharmacy teams to resolve issues related to coverage, formulary alternatives, and authorization status.

Patient Assistance Programs & Pharmacy Reps

• Support enrollment and coordination of patient assistance programs for medications when applicable.
• Work with pharmacy representatives to obtain up-to-date information on medication programs, coverage support, and patient assistance options.
• Communicate relevant assistance program details to providers and patients as appropriate.

Patient & Insurance Communication (Medication-Focused)

• Communicate with patients regarding medication-specific authorization requirements, timelines, approvals, denials, and next steps.
• Contact insurance companies to verify medication coverage, authorization requirements, and pharmacy benefits.
• Clearly explain medication authorization and refill processes to patients in a professional and empathetic manner.

Denials, Appeals & Documentation (Medications Only)

• Identify medication prior authorization denials and coordinate appeals when appropriate.
• Gather and submit medication-related clinical documentation and medical necessity information requested by payers.
• Track appeal outcomes, resubmissions, and final determinations.
• Maintain accurate and up-to-date documentation in the EMR and medication authorization tracking systems.

Workflow & Task Management

• Manage assigned work queues, tasks, and follow-ups to meet defined turnaround times.
• Prioritize requests based on scheduled dates, urgency, and payer requirements.
• Ensure all authorization activity is documented clearly and consistently.

Compliance & Quality

• Maintain compliance with payer requirements, HIPAA, and organizational policies.
• Stay up to date on payer-specific rules, authorization criteria, and changes.
• Identify trends in denials or delays and communicate opportunities for improvement.
• Support continuous improvement efforts related to authorization workflows and patient access.
• Other duties as assigned.

Requirements

Who You Are

Requirements

• Prior experience in prior authorization, insurance verification, or healthcare administration.
• Strong knowledge of insurance authorization processes and payer requirements.
• Excellent organizational and time-management skills.
• Strong written and verbal communication skills.
• Ability to work independently in a remote environment and manage multiple priorities.

Preferred

• Experience working in a specialty practice or surgical setting.
• Familiarity with EMR systems and authorization portals.
• Experience with appeals and medical necessity documentation.
• Prior experience in a remote or centralized PSC role.

Additional Job Details

• This is a full time position.
• Fully remote position if you reside in one of the following states: CO, FL, KS, MA, MI, MO, NM, OR, PA, SC, VA, WY, TX or NC.
• Compensation for this role will be $18-$24 an hour based on experience.
• Requires reliable internet access and a secure, private workspace.
• May involve high-volume authorization requests and time-sensitive deadlines.

Growth Opportunities

At Panorama Eyecare, we care about our employee’s ability to grow within the company. Therefore, we have created career growth plans that allow employees the ability to work toward their professional growth. We encourage all employees to apply for internal openings they may be qualified for, and we welcome the opportunity to interview and coach employees on how to grow.

Our Employee Perks

• PTO Accruals Start at 3 Weeks
• Comprehensive Medical and Dental Insurance
• Company Paid Optical Allowance
• Company Paid Routine Eye Care
• Short Term and Long-Term Disability Insurances
• Educational Allowance
• Generous Paid Holiday Program
• 401K With Company Match

Join Our Team!

Embark on a rewarding journey with Panorama Eyecare and become part of a team that embodies the values of Partnership, Engagement, Excellence, and Stewardship. As an Eyecare Professional, you will not only provide exceptional patient care, but also shape the future of our practices. Together, we are transforming the eyecare landscape. Apply now and let your passion for excellence and patient well-being shine!

EEOC

Panorama Eyecare 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 characteristic protected by law.