Pharmacy Prior Authorization Senior Representative - Remote, AZ

Training Schedule: 6a - 2:30p AZ Time for 4 weeks Post Training: There will be two schedules available which are 8a - 4:30p or 9:30a - 6p, AZ Time. Village Fertility Pharmacy Group (VFP), now part of Freedom Fertility Pharmacy, supports patients on their path to parenthood with compassionate service and expert clinical support. A private equity-backed network of fertility specialty pharmacies, VFP delivers best-in-class service and education. With more than 70 years of combined experience, VFP understands the complexities of infertility treatment and serves patients nationwide from Boston and locations in MA, IL, AZ, and CA. As a Pharmacy Prior Authorization Senior Representative, you will join a specialized, high-touch team supporting patients through benefits research, prior authorizations, order processing, and communication with sales, patients, and providers. This detail-oriented role is ideal for someone who excels in customer service and accurate pharmacy support. In this role, you will support a designated group of clinics and manage prior authorizations using internal and external pharmacy and clinic systems by:

• Enter prescriptions, adjudicate claims, resolve rejections, and process orders accurately.
• Use clinic-specific EMR systems to gather information needed for prior authorizations.
• Handle benefit checks, prior authorization submissions, follow-ups, and appeals.
• Research and respond to benefit and processing questions from internal sales, patients, and providers.
• Maintain compliance with contract requirements and company practices.
• Manage multiple tasks while maintaining strong attention to detail and communication.
• Participate in customer meetings, training sessions, and other program-related projects.

Qualifications:

• High school diploma or GED required.
• 2+ years of Pharmacy Technician experience.
• National Pharmacy Technician certification required.
• Active pharmacy technician license in AZ.
• Strong Microsoft Office, data entry, math, and communication skills.
• High attention to detail with the ability to multitask across phone and computer-based work.
• Experience with CoverMyMeds or similar electronic prior authorization tools preferred.
• Experience with appeals, denials, EMR systems, or infertility care is a plus.
• Strong teamwork, ownership, and time management skills.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 19 - 29 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email [email protected] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.