Capital Rx · 5 hours ago
Clinical Prior Authorization Technician (Temp, Temp-to-hire)
United States
Full-time
Remote
Entry, Mid Level
$50K/yr - $60K/yr
2+ years expJudi Health is an enterprise health technology company providing solutions for employers and health plans. They are seeking a Clinical Prior Authorization Technician to prepare prior authorization requests, validate clinical information, and ensure adherence to clinical guidelines.
Hospital & Health Care
Responsibilities
Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines
Make outbound calls to providers to obtain additional clinical information to ensure substantial clinical information exists to reach a clinical determination for pharmacist review
Proactively obtains clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review
Review and analyze pharmacy claims data for proactive outreach and intervention
Identify, document, and escalate provider concerns to the appropriate internal team including various members of the Prior Authorization Team
Triage phone calls from members, pharmacy personnel, and providers by asking applicable drug and client specific clinical questions
Effectively communicate issues and resolutions to members, pharmacy staff, providers, and appropriate internal stakeholders
Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast paced, startup environment
Qualification
Required
2+ years of pharmacy technician experience in a PBM, health plan, or in another clinical pharmacy setting
Experience handling prior authorization requests/understanding of prior authorization requirements required
National Certified Pharmacy Technician (CPhT) license, required
High school diploma or the equivalent; Associate's or bachelor's degree is preferred
Excellent communication, writing, and organizational skills
Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven call center environment
Ability to multi-task and collaborate in a team with shifting priorities
Preferred
Associate's or bachelor's degree
Company
Capital Rx
Capital Rx is now Judi Health! Navigate to our new page here: https://www.linkedin.com/company/judi-health
501-1000 employees
H1B Sponsorship
Capital Rx has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (2)
2023 (1)
2022 (1)
2021 (5)
Funding
Current Stage
Late StageLeadership Team
A. J. Loiacono
CEO
Ryan Kelly
CTO
Recent News
2025-10-01
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Tech Startups - Startups and Technology news
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