{"id":3330314,"url":"https://alion.io/job/procare-rx-prior-authorization-coordinator","title":"Prior Authorization Coordinator","company":{"id":4480531,"name":"ProCare Rx","domain":"procarerx.com","url":"https://alion.io/company/procare-rx","size_band":null,"is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":null,"truth_index":null},"role":"Administrative","role_family":"Administrative","seniority":null,"employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"inferred_company_offices","remote_working_hours":null,"hiring_geo_confidence":"inferred","locations":[],"countries":[],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":21,"max":23,"currency":"USD","period":"hour","gross":null,"usd_annual":46000},"salary_estimate":null,"experience_years_min":null,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false}],"status":"live","first_seen_at":"2026-10-27T09:16:47Z","employer_posted_date":null,"last_verified_at":"2026-10-27T09:16:47Z","board_verified":false,"closed_at":null,"days_open":4,"trust":{"level":"not_scored","repost_count":null,"flags":[],"days_open":4},"description":"Status: Hourly, Non-ExemptHourly Rate: $21.00 - $23.00JOB RESPONSIBILITIES\nManage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored patient support programs, utilizing payer portals, electronic submission platforms, fax, and telephonic outreach to facilitate timely access to therapy.\n\nServe as a central coordination point between prescribers, specialty pharmacies, payers, and internal HUB teams to ensure seamless progression from benefits investigation through authorization approval and therapy initiation.\n\nConduct comprehensive benefits verification and coverage analysis to identify prior authorization requirements, payer restrictions, and potential access barriers; initiate and track PA submissions accordingly.\n\nSubmit accurate and complete prior authorization requests, including all required clinical documentation, and perform proactive follow-up with payers to expedite determinations and minimize delays in therapy access.\n\nPartner closely with provider offices to obtain clinical information, clarify prescribing intent, and support the development and submission of first-level appeals, reconsiderations, and medical exception requests.\n\nCollaborate cross-functionally with HUB teams including reimbursement, copay assistance, patient assistance programs (PAP), and specialty pharmacy partners to remove financial and administrative barriers to treatment.\n\nMaintain detailed, compliant documentation of all case activities, payer interactions, and authorization statuses within the HUB CRM system to ensure transparency, reporting accuracy, and audit readiness.\n\nEvaluate authorization outcomes to determine next steps, including appeals, bridge program eligibility, or alternative access solutions in alignment with manufacturer program.\n\nMonitor therapy status and coordinate prior authorization renewals or reauthorizations to support continuity of care and prevent treatment interruptions.\n\nEnsure adherence to all regulatory and privacy requirements, including the Health Insurance Portability and Accountability Act (HIPAA), as well as manufacturer program policies and standard operating procedures.\n\nDeliver a high-touch customer experience by maintaining professional, empathetic communication with patients and healthcare providers throughout the access\n\nSupport onboarding and ongoing training of team members; contribute to knowledge sharing and best practices within the HUB environment.\n\nDemonstrate strong knowledge of payer landscapes, specialty pharmacy workflows, and manufacturer HUB services, ensuring alignment with program-specific requirements.\n\nPerform additional duties as needed to support patient access objectives and overall HUB program success.\n\nQUALIFICATIONS AND REQUIREMENTS\nPrevious Experience:\n\nPrevious experience in managing prior authorizations or working knowledge of the prior authorization process is highly preferred.\n\nStrong understanding of medical terminology, insurance plans and authorization.\n\nBilingual English/Spanish is a plus.\n\nMinimum 3 years of pharmacy or healthcare experience.\n\nAbility to manage cases from multiple clientele programs and follow program business.\n\nProficiency with data entry functions, Microsoft applications, and hands-on computer skill.\n\nAbility to work independently and on a team.\n\nExcellent communication, problem solving and customer service.\n\nStrong organizational /interpersonal skills; attention to detail and the ability to multitask.\n\nAbility to use multiple PC monitors and navigate through several software systems effectively.\n\nEducation:\nHigh School Graduate required, College degree preferred.\n\nState Pharmacy Technician registration or PTCB National Certification preferred.\n\nPhysical Demands:Requires sitting, standing, and occasional light lifting.\nThis is a full-time position with benefits. Please visit our Contact Us/Opportunities page on our website for more information about our benefits list.\nProMod 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 .\nProMod Rx is an Equal Opportunity Employer.\nOriginally posted on Himalayas","description_format":"text","description_chars":4312,"description_truncated":false,"requirements":{"experience_years_min":null,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["Health insurance"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":[],"lifecycle":[{"event":"open","at":"2026-10-27T11:29:30Z"}],"visa":[],"liveness":{"score":86,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.86,"p_room":1,"age_days":3,"expected_fill_days":27,"reasons":["seen:3","win:early"],"computed_at":"2026-10-31T05:58:55Z"},"pay":{"stated_usd_annual":46000,"is_top_pay":false},"html_url":"https://alion.io/job/procare-rx-prior-authorization-coordinator","json_url":"https://alion.io/job/procare-rx-prior-authorization-coordinator.json","meta":{"generated_at":"2026-10-31T12:54:47Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":19985,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-11-01T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":4480531},"rest":"https://alion.io/mcp/rest/get_company?id=4480531"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fprocare-rx-prior-authorization-coordinator"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fprocare-rx-prior-authorization-coordinator"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fprocare-rx-prior-authorization-coordinator"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/procare-rx-prior-authorization-coordinator\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fprocare-rx-prior-authorization-coordinator"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":3330314}},{"tool":"search_jobs","arguments":{"company":"procarerx.com","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":3330314},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. 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