About CoreLife:
CoreLife is a patient-centered healthcare organization focused on transforming lives by addressing the root causes of obesity and related chronic conditions. Our unique model combines clinical care, nutrition, exercise, and behavioral health to help patients achieve lasting results. We are growing rapidly and looking for passionate individuals who want to make a real impact.
Position Overview:
We are seeking a Medication Prior Authorization Specialist to join our growing team. This role plays a key part in supporting CoreLife’s providers and patients in securing access to prescribed medications for obesity treatment. You will serve as the subject matter expert on insurance-specific plan requirements and help navigate prior authorization processes for commercial and government payers.
Key Responsibilities:
Partner with providers and internal teams to ensure seamless patient care.
Review and process medication refills and prior authorizations in compliance with state and federal regulations.
Assist patients with accessing manufacturer coupons and completing medication assistance applications.
Closely monitor all prior authorization requests and ensure timely submission of all necessary documentation.
Coordinate follow-up actions and submit appeals for denied authorizations when appropriate.
Maintain accurate records in the CRM system and ensure PHI is secured in compliance with HIPAA.
Respond promptly to patient and insurance inquiries via phone or email.
Collaborate cross-functionally with departments to verify medication benefits.
Provide excellent customer service and contribute to continuous process improvements.
Meet turnaround time and quality performance standards.
Qualifications:
Pharmacy Technician, LPN, Medical Assistant, or a minimum of 2 years’ experience in medication prior authorization or a similar role
PTCB certification preferred
Skills & Competencies:
Strong knowledge of generic and brand-name medications, dosage, and administration
Excellent written and verbal communication skills
Organized, detail-oriented, and able to multitask in a fast-paced environment
Basic proficiency with technology and software systems
Ability to work both independently and collaboratively
Demonstrated commitment to patient care and confidentiality
Note: reasonable accommodations may be made available for individuals with disabilities to perform the essential functions of this position.
...A Camp Counselor is an important member of our field team. They help create magical and impactful day camps for children ages 5-12 and teens ages 13-17. A Summer Camp Counselor works throughout our summer camp season, which runs May through August. As a Camp Counselor...
...Seasonal Tax Preparer (Potential Long-Term Opportunity) Company: Fiesta Auto Insurance Our Mission: At Fiesta Auto Insurance, we believe... .... All of our Fiesta Auto Insurance offices also offer income tax preparation services. Our team of professionals will ask you...
...coaches and performers far and wide! Independent Lake Camp is on a mission to create the best summer ever for their campers and we need you on board! If... .... Independent Lake Camp attracts campers and counselors from all over the USA and abroad, catering to kids aged...
...using Zoom, email, and online tools Must be 18+ and authorized to work in the U.S. Motivated, reliable, and eager to learn What We... ...Customer Service Jobs Entry-Level Remote Jobs Work From Home Hiring Now Sales & Benefits Advisor No Experience Jobs Customer...