Pharmacy Prior Authorization Representative - Remote CT

Your role in our mission

• Serve as a primary point of contact for prescribers and pharmacies regarding pharmacy claims and prior authorization inquiries

• Analyze pharmacy claims and provide accurate clarification, verification, and resolution to provider inquiries

• Process prior authorization requests, including approvals and denials, and document rationale in accordance with policy

• Accurately document all call interactions, inquiries, decisions, and resolutions in the system

• Maintain confidentiality and compliance with HIPAA and Connecticut Medicaid guidelines