Clinical Services/Prior Authorization Representative

Clinical Services/Prior Authorization Representative Job Category: Pharmacy Requisition Number: PRIOR001714 Full-Time On-site Locations Showing 1 location ESSENTIAL DUTIES AND RESPONSIBILITIES Manage incoming and outgoing calls, documenting all calls in the dedicated application for call documentation. Handle letters to and from 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. Assist 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 in training new employees. Participate in training, conferences, orientations, and other activities related to our business unit. Maintain a flexible work schedule to meet changing department needs. QUALIFICATIONS AND REQUIREMENTS Pharmacy technician certification (CPhT) required; registered preferred. Prefer two years’ experience working as a pharmacy technician or as a physician office assistant handling phone calls and reviewing charts. One year’s experience contacting other healthcare providers as part of daily job preference. Excellent communication skills in a professional environment. Strong organizational skills working under time constraints in a constantly changing environment. PC experience navigating 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). Position requires strong multitasking skills, attention to detail, and the ability to lift and/or move up to 20 lbs. BENEFITS Comprehensive Health Benefits: Medical, Dental, Vision, Short‑Term/Long‑Term Disability Insurance, Life insurance. Paid vacation and holiday pay. Robust Employee Wellness Program. 401(k) with company match. Employee Assistance Program provides confidential support and counseling. Employee referral program. For inquiries, please contact our official recruitment team at View email address on click.appcast.io. ProCare Rx is an 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. #J-18808-Ljbffr