Prior Authorization Specialist

About the role

This role is responsible for prior authorization workflows, patient-specific electronic fax management, and clinical support within the EPIC EMR, ensuring timely, accurate coordination across patients, providers, and clinic staff. The ideal candidate brings strong organizational discipline, clear communication, and the ability to operate effectively in a fast-paced clinical environment. Success in this role requires attention to detail, comfort with structured processes, and a commitment to supporting reliable, patient-centered care. Core Responsibilities Complete medication and procedural prior authorizations through CoverMyMeds, payer portals, phone calls, and electronic systems. Communicate with insurance companies to clarify coverage requirements, criteria, and documentation needs. Collaborate with providers to gather clinical information needed for approvals. Communicate with patients regarding prior authorization updates, medication issues, or required documentation. Track, follow up, and document all authorization statuses to ensure timely patient access to care. Assist providers and nurses with prior authorization questions, refill coordination, and pharmacy communication. Monitor, organize, and route incoming e-faxes to the appropriate clinical team members in EPIC Ensure timely processing of forms, lab results, medication requests, and other clinical documents incoming from e-fax Support clinic staff with administrative tasks such as scheduling, patient outreach, and medical record requests. Assist in coordinating referrals, diagnostic testing, and follow-up care. Maintain confidentiality and compliance with HIPAA and clinic policies. Required Qualifications 2+ years of experience with prior authorizations or insurance verification strongly preferred. Certified Medical Assistant (CMA/RMA) or Pharmacy Technician (CPhT) strongly preferred. Familiarity with EPIC Strong communication, problem-solving, and organizational skills. Ability to work both independently and collaboratively within a clinical team. Knowledge of medical terminology, medications, and insurance processes Why Join Anchor Health Here, your work has meaning for your team, your patients, and your community. We offer competitive pay, growth opportunities, and a culture grounded in trust, respect, and collaboration. Join us in shaping the future of inclusive healthcare in Connecticut. Apply today and help us care for every person exactly as they are. Salary Range The salary range for this role is $48,000- $62,000 annually. Compensation within this range is determined based on relevant experience, licensure, skills, scope of responsibility, and internal equity. The full range reflects the potential for growth within the role; most new hires are typically placed between the minimum and midpoint of the range, depending on qualifications. Anchor Health maintains structured salary bands and reviews compensation periodically to ensure alignment with market conditions, organizational needs, and individual performance.

Benefits

Additional Information

About Anchor Health Anchor Health is Connecticut's leading center for inclusive, person-centered healthcare. We deliver compassionate, evidence-based primary, behavioral, and gender-affirming care for the LGBTQ+ community and beyond. Our mission is to empower every individual to live their healthiest life through exceptional, affirming care. At Anchor, you'll join a collaborative team redefining what inclusive healthcare looks like across Connecticut with breaking down barriers, affirming identity, and raising the standard of care for all.

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