Job Description

Job Description

Job Description

We are seeking an energetic, detail-oriented Prior Authorization Specialist to join our team and play a key role in helping patients access life-changing specialty medications. If you're passionate about patient care and experienced in the specialty pharmacy ecosystem, we want to hear from you!

This role is 100% onsite and focused on supporting healthcare providers through the prior authorization (PA) process - from benefit verification to successful submission and follow-up.

• Job Opening: Prior Authorization Specialist
• Location: Onsite - Strip District, Pittsburgh, PA (15222)
• Pay: $22/hour
• Schedule: Monday - Friday, 40 hours/week
• Start Date Requirement: Must be available to work on January 1, 2026 (no exceptions). Ideally looking for someone on the sooner side.
• Shift Flexibility: Between 8:00 AM and 6:00 PM (standard 8-hour shift within this window)

Key Responsibilities:

• Communicate with prescriber offices to facilitate all steps of the PA process (via phone, chat, and email)
• Use various technology platforms to gather, submit, and track prior authorization cases
• Conduct benefit verifications and navigate insurance requirements for both pharmacy and medical benefits
• Assemble complete case files using clinical documentation like chart notes, lab results, and medication histories
• Troubleshoot and follow up with payers until a final determination is reached
• Collaborate with internal teams to ensure process efficiency and patient-first outcomes

Required Background & Experience:

• Minimum 2 years of specialty pharmacy experience with a focus on prior authorization and benefit verification
• Strong understanding of drug names, medical terminology, and insurance workflows
• Excellent verbal and written communication and customer service skills
• Comfortable using evolving technologies and general computer proficiency
  

Preferred Skills & Competencies:

• Highly organized and detail-oriented
• Strong time management and prioritization abilities
• Critical thinking and independent problem-solving skills
• Able to work independently while contributing positively to a collaborative team environment

What You'll Be Doing (Day-to-Day):

Think of this role as being the engine of the authorization process. You'll be the go-to expert who quarterbacks each case from start to finish:

• Investigate: Start each case with a detailed benefit verification to identify insurance requirements
• Communicate & Gather: Reach out to providers to collect necessary documentation
• Assemble & Submit: Compile "clean" cases and submit through payer portals
• Follow-Up & Troubleshoot: Proactively track submissions and resolve issues until final determination



Why Join Us?

• Help real patients get the treatments they need
• Be part of a mission-driven, solutions-focused team
• Work in a vibrant part of Pittsburgh's Strip District
• Stable full-time hours with a competitive hourly wage

Ready to Apply?
If you're experienced, motivated, and ready to make a difference in patient care, we'd love to hear from you. Apply today!

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Job Tags

Hourly pay, Full time, Local area, Monday to Friday, Shift work,

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