Authorization Representative II (Specialty Pharmacy)

Location: Hybrid role requiring 1–2 in-office days per week at offices in Lake Mary, Florida; St. Louis, Missouri; Harvey, Louisiana; or Denver, Colorado. Candidates must live within reasonable commuting distance of a posting location.

Salary: $17.89–$29.52 per hour, depending on geographic location, experience, education, and skills.

Company

hirify.global is a Fortune 25 healthcare company focused on improving lives and communities and simplifying healthcare. BioPlus Specialty Pharmacy provides specialty medication access, clinical expertise, digital capabilities, and personalized treatment support.

What you will do

• Review prior authorization requests for accuracy, completeness, and required supporting documentation.
• Assist with medical necessity documentation and follow up to expedite approvals.
• Collaborate with internal departments to obtain prior authorizations and appeals.
• Document insurance interactions and authorization details in company systems.
• Review payer denials and submit appeals when permitted.
• Contact physician offices to obtain demographic and medical information.

Requirements

• High school diploma or GED.
• At least 2 years of experience processing pharmacy prior authorizations.
• At least 1 year of experience applying Medicare, Medicaid, and managed care reimbursement guidelines, or an equivalent combination of education and experience.
• Ability to work in the office 1–2 days per week and reside within commuting distance of a listed location.
• Monday–Friday availability, 8:00 a.m.–5:00 p.m.

Nice to have

• Specialty pharmacy experience.
• Medical terminology training.
• Oncology experience.

Culture & Benefits

• Hybrid work structure combining scheduled office collaboration with virtual work flexibility.
• Paid holidays, paid time off, and incentive bonus programs.
• Medical, dental, vision, disability, life insurance, and wellness benefits.
• 401(k) matching, stock purchase plan, and financial education resources.
• COVID-19 and influenza vaccination may be required for certain patient- or member-facing roles, subject to applicable accommodations and laws.