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Prior Authorization Specialist

Epitec, Inc

Detroit, MI

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JOB DETAILS
SALARY
$22–$25 Per Hour
SKILLS
Adjudication, Analysis Skills, Certified Pharmacy Technician (CPhT), Claims Processing, Communication Skills, Compensation and Benefits, Computer Systems, Customer Support/Service, Documentation, Drug Terminology, Formulary, Healthcare Providers, High School Diploma, Hospital, Medicare, Medications, Microsoft Office, Pharmacy, Prescription Drugs, Retail, Systems Administration/Management
LOCATION
Detroit, MI
POSTED
Today
Job Title:
Prior Authorization Specialist
Location:
Detriot, MI- Hybrid
Employment Type: 
W2 Contract
Contract Length: 
12 months
Pay Range:
$22-25 per hour

Job Overview
We are hiring a Prior Authorization Specialist to provide support to pharmacists, physicians, and healthcare providers regarding Medicare Part D and Commercial pharmacy benefits. This role is responsible for analyzing prescription drug coverage, assisting with prior authorization requests, answering pharmacy benefit inquiries, and supporting claims adjudication processes. The ideal candidate will have pharmacy experience, strong customer service skills, and knowledge of prescription drug terminology and benefits.


Key Responsibilities
  • Support providers with Medicare Part D and Commercial pharmacy benefit questions and coverage determinations.
  • Review and process prior authorization requests in accordance with established guidelines.
  • Respond to drug coverage inquiries and explain pharmacy benefit information.
  • Analyze prescription claims and assist with claim adjudication issues.
  • Research medication coverage, formulary status, and therapeutic alternatives.
  • Maintain accurate documentation of provider interactions and case activity.
  • Utilize Microsoft Office applications and internal systems to manage workflow and communications.
  • Deliver exceptional customer service while handling a high volume of provider inquiries.

Required Qualifications
  • High School Diploma or GED.
  • Minimum 2 years of retail or hospital pharmacy experience.
  • Experience with pharmacy claim adjudication.
  • Knowledge of prescription drug names, therapeutic classes, and pharmacy terminology.
  • Strong customer service and communication skills.
  • Proficiency with Microsoft Office applications and computer systems.
  • Understanding of basic drug classifications and medication therapies.

Preferred Qualifications
  • Pharmacy Technician Certification (PTCB).
  • Experience with Medicare Part D prescription benefits.
  • Previous prior authorization or pharmacy benefit management experience.
  • Associate degree or completion of two years of college coursework.

#INDEPI 

About the Company

E

Epitec, Inc

Epitec is a leading staffing and recruiting services company with a mission to make staffing personal. We go beyond traditional hiring by truly understanding our candidates and matching them with the perfect opportunities. We offer competitive compensation, career growth, and support throughout the entire process. Working with top Fortune 500 companies, we are recognized for our excellence with numerous awards, including Best & Brightest and diversity recognitions. At Epitec, we're redefining the future of employment. 

COMPANY SIZE
2,500 to 4,999 employees
INDUSTRY
Staffing/Employment Agencies
EMPLOYEE BENEFITS
Professional Development, 401K, Employee Referral Program, Life Insurance
FOUNDED
1978
WEBSITE
https://epitec.com/

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