Job Description

As a Pharmacy Prior Authorization Senior Representative , you will be working on a specialized team focused on high touch programs to assist our patients. This role is very detail oriented, and you'll spend the majority of your day researching benefits, obtaining prior authorizations, processing orders and talking to patients and/or providers. Our representatives are dedicated team members who excel at customer service, helping us elevate our pharmacy patient care to new heights.


In this role, you will be part of Sr. Tech workgroup on a Tier 3 Insurance Verification Team that will focus on the following:

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  Accurately enter prescriptions into our system, adjudicate claims and work rejections, and support patients with their medication orders. Use the knowledge you gain from training, your problem-solving skills and support from your team to accurately process prescription claims so they will be dispensed accurately.

• Rapid and thorough investigation of processing/benefit inquiries from Freedom Inside Sales team.

• Insurance Inquiries/benefit checks.

• Cross trained in multiple areas while maintaining proficiency and accuracy.

• Juggle multiple tasks without sacrificing attention to detail.

• Help patients understand their pharmacy benefits better and answer patient calls effectively.

• Use empathy and your strong communication skills to handle patient questions, payment method processing, and prior authorization follow up.

What you need to do the job:

• 
  High School Diploma, or GED required.

• 2+ years pharmacy technician experience.

• Valid National Pharmacy Technician certification is required.

• Valid Arizona State pharmacy technician license is required.

• Microsoft Office proficiency and data entry skills.

• Strong math skills related to prescription calculations.

• Exceptional attention to detail, accuracy, and quality.

• Excellent verbal and written communication skills.

Ability to work a rotating work schedule:

9AM -5:30 PM EST 3 days/week;
10:30AM-7PM EST 1 day/week
12:30 PM -9 PM EST 1 day/week.
There is also a Saturday shift of 9 AM -6 PM EST which happens about every 4 weeks.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 19 - 29 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Job Tags

Hourly pay, Full time, Work at office, Local area, Remote work, Shift work, 3 days per week, 1 day per week,

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