Pharmacy Prior Authorization Specialist (Remote)

 Posted 3 hours ago
     
2-5 years experience
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AI Summary

The specialist serves as a liaison between pharmacists, healthcare facilities, and insurance plans to facilitate medication access and manage prior authorization requests. They are responsible for investigating payment denials, documenting clinical justifications, and ensuring compliance with authorization guidelines.

Pharmacy Prior Authorization Specialist (Remote)

Location: Remote (Nationwide)

Schedule: Monday-Friday | 11:00 AM - 7:30 PM CST

About the Role

We are seeking a detail-oriented Pharmacy Prior Authorization Specialist to support a high-volume clinical operations team. This role serves as a key liaison between pharmacists, healthcare facilities, physicians, and prescription drug plans to facilitate medication access and ensure timely completion of prior authorization requests.

The ideal candidate will have experience working in pharmacy operations, prior authorizations, and healthcare documentation, with a strong commitment to accuracy and customer service.

Key Responsibilities

  • Serve as a primary point of contact for prior authorization requests and therapeutic interchange communications.
  • Collaborate with pharmacists, healthcare facilities, physicians, and prescription drug plans (PDPs) to coordinate authorization activities.
  • Research and investigate medication payment denials to identify root causes and next steps.
  • Contact insurance plans and healthcare facilities to obtain additional information regarding denied claims or authorization requirements.
  • Complete, submit, and track prior authorization requests in accordance with established guidelines.
  • Document clinical justifications and authorization activity accurately and thoroughly.
  • Maintain detailed records within EMAR and other applicable systems.
  • Ensure timely follow-up on pending requests and outstanding documentation.
  • Uphold quality, compliance, and service standards while managing multiple priorities.

Required Qualifications

  • High school diploma or equivalent.
  • Prior experience processing pharmacy prior authorizations.
  • Strong knowledge of healthcare insurance, prescription benefits, and authorization workflows.
  • Excellent verbal and written communication skills.
  • Strong organizational skills and attention to detail.
  • Proficiency with EMAR systems and healthcare documentation platforms.
  • Ability to work independently in a remote environment while managing competing priorities.

Preferred Qualifications

  • Certified Pharmacy Technician (CPhT) certification.
  • Experience in specialty pharmacy, retail pharmacy, long-term care pharmacy, or managed care environments.
  • Knowledge of therapeutic interchanges and medication coverage requirements.
  • Experience communicating with insurance plans, healthcare providers, and clinical teams.

Job Type & Location

This is a Contract position based out of Arlington, TX.

Pay and Benefits

The pay range for this position is $22.75 - $22.75/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Aug 12, 2026.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.

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