The Prior Authorization Specialist provides essential clinical and administrative support by coordinating patient care activities, managing prior authorizations, and ensuring accurate documentation across systems. This role works closely with providers, pharmacists, and patients to maintain smooth workflows, timely approvals, and high-quality service in a fast-paced healthcare environment.
· Process and manage prior authorizations for medications and procedures.
· Book, confirm, and manage patient appointments.
· Coordinate and communicate with pharmacists regarding medication-related needs.
· Enter, update, and maintain accurate patient information in the EMR.
· Communicate with patients for follow-ups, reminders, and general inquiries.
· Prepare and handle prescriptions (Rx) as directed by providers.
· Track authorization status and follow up to ensure timely approvals.
· Maintain organized records and documentation for audits and compliance.
· Support efficient patient workflow and daily clinic operations.
· Utilize communication tools to collaborate with internal and external teams.
· Perform other administrative and clinical support duties as assigned.
· Proven experience as a Medical Assistant or Prior Authorization Specialist.
· Familiarity with prior authorization processes for medications and procedures.
· Experience with AdvancedMD EMR (preferred).
· Experience using CoverMyMeds or similar authorization platforms.
· Strong English communication skills, both written and verbal.
· Spanish-speaking ability preferred but not required.
· Highly organized, detail-oriented, and proactive work style.
· Comfortable multitasking and working in a fast-paced, tech-driven environment.
· Ability to use communication platforms such as RingCentral.
· Reliable workstation setup, including a secondary monitor.
