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Prior Authorizations Representative

Addison Group • Contract • Elk Grove Village, Illinois, United States • 1d ago

Job Title: Prior Authorizations Representative

Location: Elk Grove Village, IL (Hybrid – 2-3 days on site per week)

Compensation: $21–$24 per hour (depending on experience)

Industry: Healthcare / Specialty Pharmacy

Work Schedule: Monday–Friday, 8am–5pm CST

Benefits: This position is eligible for medical, dental, vision, and 401(k).

About Our Client:

Addison Group is partnering with a leading healthcare organization that provides patients with access to advanced therapies and life-changing treatments. They are seeking detail-oriented and motivated Complex Prior Authorizations Representatives to support their growing team.

Job Description:

This is a full-time contract position where you will manage complex prior authorizations for specialty medications. Working alongside the Benefits Verification team, you will review prescriptions, validate insurance coverage, obtain clinical documentation, and initiate authorizations. This role requires strong communication skills, attention to detail, and prior experience in specialty pharmacy or infusion services.

Key Responsibilities:

Verify benefits with major medical and pharmacy plans based on requests from the verification team
Contact physician offices to obtain current prescriptions and clinical documentation
Review and validate documentation against insurance plan requirements
Initiate prior authorizations using online platforms (e.g., CoverMyMeds, payer portals)
Follow up on pending authorizations within set timelines
Respond to urgent internal requests from patient care teams and management
Obtain and track approval and denial letters
Manage re-authorizations before expiration dates
Maintain accurate records and participate in audits as needed

Qualifications:

2+ years of prior authorization or benefits verification experience in a specialty pharmacy or infusion setting (required)
Knowledge of medical and pharmacy benefits, including Commercial, Medicaid, and Medicare plans
Familiarity with insurance portals, CoverMyMeds, Availity, and clinical documentation
Strong understanding of HCPC and ICD-10 codes, prescriptions, and payer requirements
Excellent communication skills for working with physicians, insurance carriers, and internal teams
High attention to detail and ability to multitask in a fast-paced environment
Collaborative, professional, and patient-focused mindset

Perks:

Competitive hourly pay
Hybrid schedule (flexibility to work remotely 2-3 days per week)
Opportunity to gain valuable experience with a nationally recognized healthcare organization
Professional development through ongoing training and mentorship

Additional Details:

Contract role through March 2026
Free on-site parking
Training provided through peer-to-peer shadowing and structured check-ins
Equipment (laptop, monitor) provided
Dress code: business casual/professional when on camera

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

IND 004-008

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