Prior Authorization Coordinator I (Healthcare)

Location: San Diego, California, United States. The position is on-site at the San Diego headquarters or another company location; remote work is possible only with management approval based on business requirements. Typical hours are Monday through Friday, 8:00 a.m. to 5:00 p.m., with occasional nights, weekends, holidays, or overtime as needed.

Salary: $17.69–$27.41 per hour.

Company

hirify.global is a privately held pharmacy benefit manager providing pharmaceutical and technology-related solutions to payers, providers, and consumers.

What you will do

• Process, prioritize, and finalize prior authorization requests within client turnaround times and performance requirements.
• Review formulary alternatives, tried and failed medications, drug references, and indication requirements.
• Enter prior authorization data, document approvals or non-approvals, and fax status updates to physicians and pharmacies.
• Research and resolve processing issues by contacting clients, members, physicians, and pharmacies for missing information.
• Coordinate with clinical pharmacists, client teams, contact center services, supervisors, and subject matter experts.
• Protect the confidentiality and privacy of prior authorization and member information.

Requirements

• GED or high school diploma and at least one year of experience, or an equivalent combination of education and experience.
• Intermediate knowledge of Microsoft Word, Excel, Outlook, Windows-based database programs, and the ability to learn new applications.
• Successful completion of a national certification exam or state licensure in any U.S. state.
• Current unrestricted Pharmacy Technician License and/or CPhT certification.
• Ability to interpret instructions, analyze information, solve problems, and communicate effectively with customers, clients, and colleagues.
• This position is not eligible for visa sponsorship.

Culture & Benefits

• Team-oriented environment focused on high performance, innovation, and improving healthcare value.
• Medical, dental, vision, and wellness programs.
• Paid time off and company-paid holidays.
• 401(k) with company match, life and disability insurance, and incentive compensation.
• Tuition reimbursement and employee referral bonus.