Medication Prior Authorization MA/LPN - $500 Sign-on Bonus

$500 Sign-on Bonus

Once training is complete, this role can work one day a week from home and one day a week in office.

Scope-Purpose:
The Medication Prior Authorization (PA) MA/LPN is responsible for coordinating and processing medication prior authorizations to ensure timely patient access to prescribed therapies. This role serves as a liaison between providers, pharmacies, insurance companies, and patients while supporting medication management and reducing administrative burden on clinical staff.

Responsibilities (included, but not limited to):
Prior Authorization Management (Primary Function)

• Review medication prior authorization requests submitted by providers.


• Gather required clinical documentation, laboratory results, and supporting records.


• Complete and submit medication prior authorizations through electronic portals, fax, or phone.


• Monitor authorization status and ensure timely follow-up on pending requests.


• Communicate approval, denial, or additional information requests to providers and patients.


• Coordinate appeals and reconsiderations for denied medication requests.


• Maintain accurate documentation in the Electronic Health Record (EHR).


• Track authorization turnaround times and outcomes for reporting purposes.


• Collaborate with providers to identify alternative medications when coverage is denied.

Clinical Support

• Utilize clinical knowledge to review diagnoses, treatment history, and supporting documentation needed for medication approval.


• Assist with medication refill workflows as assigned.


• Support quality initiatives related to medication adherence and patient access.


• Provide patient education regarding authorization processes and expected timelines.


• Assist nursing and provider teams with medication-related administrative tasks.
  


• Serve as a point of contact for pharmacies regarding authorization status.


• Communicate effectively with insurance representatives, pharmacies, patients, and staff.


• Work closely with providers, nurses, medical assistants, referral coordinators, and care management staff.
  

Education and Experience Requirements:
For MA Candidates:
Current Certified Medical Assistant (CMA), Registered Medical Assistant (RMA), or equivalent certification.
Minimum one (1) year of outpatient clinical experience.
Experience working with EMR systems.
Knowledge of medical terminology, diagnoses, and medications.

For LPN Candidates:
Current Missouri LPN license.
Minimum one (1) year of clinical nursing experience.
Experience in ambulatory care, family practice, or community health preferred.
Experience working with EMR systems.
Knowledge of medical terminology, diagnoses, and medications.

Additional Requirements:
Prior authorization experience required.
Knowledge of insurance plans, formularies, and pharmacy benefit processes preferred.Familiarity with CoverMyMeds, CyberAccess, or other authorization platforms preferred.

Benefits:

• PTO


• Fitness Benefit – Fordland Clinic encourages health and wellbeing and will contribute up to $50 per year for a fitness facility membership, or other approved fitness expenses.


• “Thank You” recognition program through Motivosity, redeemable for gifts and gift cards.

Work hours: part-time, hourly position. Once training is complete, this role can work one day a week from home and one day a week in office. Clinic hours are 8am to 6pm Monday through Friday and Saturdays 8am to 4pm. This position may be scheduled to work any of the days the clinic is open (Monday through Saturday) and may be scheduled to arrive 15 minutes prior to opening and may be scheduled to leave one hour after closing, depending on patients scheduled.