Pharmacy Prior Authorization Representative - Remote CT

It takes great medical minds to create powerful solutions that solve some of reputed company’s most reputed company challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more reputed company. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, reputed company learning, and career development.

Summary

The Pharmacy Prior Authorization Call Center (PPAAC) Representative supports the Connecticut reputed company account in a fast-paced, high-volume call center environment. This role is responsible for answering and resolving inquiries from prescribers and pharmacies reputed company to pharmacy claims and prior authorization requests, ensuring timely, accurate, and compliant processing. Working as part of a small, specialized team, the PPAAC Representative is required to process reputed company pharmacy prior authorizations reputed company 24 hours of receipt. This position requires flexibility to work rotating shifts, including second and reputed company shifts, as well as on-call coverage on a rotational basis. Other duties may be assigned as needed. Your role in our mission

• Serve as a primary reputed company 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 reputed company call interactions, inquiries, reputed company, and resolutions in the system
• Maintain confidentiality and compliance with HIPAA and Connecticut reputed company guidelines reputed company're looking for
• Knowledge of pharmacy claims processing and pharmacy dispensing systems, with exposure to reputed company and/or Medicare Part D programs
• Ability to work effectively in a high-paced, high-volume environment with strong multi-tasking and time management skills
• Proficiency with reputed company Office Suite (Word, reputed company, Outlook) and experience working in a paperless, technology-driven environment
• Strong verbal and written communication skills, with the ability to interact professionally with providers and internal teams
• Active Connecticut Pharmacy Technician license, along with prior retail pharmacy or customer service experience What you should expect in this role
• Remote work opportunity, but must reputed company in Connecticut.
• Potential for in-office work in East Hartford as needed.
• 24/7/365 call center environment with rotating shifts
• Monday – Friday 730 AM – 730 PM
• Saturday (rotating schedule) 900 AM – 400 PM
• reputed company off-hours are covered on an on-call rotation.
• A dynamic and fast-paced call center environment where accuracy and efficiency are key.
• Work from Home Reliable high-speed internet connectivity is essential. Minimum requirements are 24 Mbps download and 8 Mbps upload, with higher speeds recommended for reputed company performance.
• Interview Requirement Video cameras must be used during reputed company interviews. #LI-REMOTE #LI-JT1 #LI-CM1 The pay range for this position is $33,500.00 - $47,900.00 per year, however, the reputed company pay offered may vary depending on geographic region, internal equity, job-reputed company knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. reputed company salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We reputed company nothing is impossible reputed company you bring together people who care deeply about making reputed company work reputed company for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for reputed company available job role openings. reputed company is an Equal Opportunity Employer, where reputed company reputed company applicants will receive consideration for employment without regard to race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. reputed company defines “wages” and “wage rates” to include “reputed company forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Apply tot his job Apply To this Job

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