Prior Authorization/Insurance Verification Specialist

ICONMA

Full-time Business Operations Specialists
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Location
Providence, Rhode Island, United States
Posted
July 08, 2026

Job Description


Our Client, a Retail Pharmacy, is looking for multiple Prior Authorization/Insurance Verification Specialists to work remotely. 
 

Responsibilities:
  • Receives in-coming calls from members, providers, etc. providing professional phone assistance to all callers through the criteria based prior authorization process.
  • Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions and judgment calls to the pharmacist.
  • Utilizing multiple software systems to complete Medicare appeals case reviews
  • Meeting or exceeding government mandated timelines
  • Complying with turnaround time, productivity and quality standards
  • Conveying resolution to beneficiary or provider via direct communication and professional correspondence
  • Acquiring and maintaining basic knowledge of relevant and changing Med D guidance


    • Requirements:
  • Minimum () year experi...

    • Job Details

    • Job Type
      Full-time
    • Category
      Business Operations Specialists
    • Date Posted
      July 08, 2026
    • Application Deadline
      August 17, 2026