*New - Prior Authorization Specialist (Experience)- Remote
Company: NYX Health, LLC
Role summary
*New - Prior Authorization Specialist (Experience)- Remote is a role at NYX Health, LLC in Kansas City, Missouri, United States (remote). Posted 2026-08-13. Experience level: 5-10.
- Job title
- *New - Prior Authorization Specialist (Experience)- Remote
- Company
- NYX Health, LLC
- Location
- Kansas City, Missouri, United States
- Work arrangement
- remote
- Category
- Software Engineering
- Experience level
- 5-10
- Date posted
- 2026-08-13
Job description
Prior Authorization Specialist – Remote
Position Summary
We’re looking for a driven, detail‑oriented individual to join our team as a Prior Authorization Specialist. You’ll receive training and ongoing support to set you up for success. As part of this role, you’ll complete accurate insurance verifications and prior authorizations to ensure timely reimbursement. You’ll also collaborate with clinicians and insurance payors in a fast‑paced environment to manage claims, documentation, and approvals. If you enjoy problem‑solving, staying organized, and making a meaningful impact—both independently and as part of a team—we’d love to hear from you.
Key Responsibilities
Pharmacy Benefits PA Submissions
Navigating EMR/PM systems for demographic information, patient clinical notes, and labs.
Coordinate initial submission of prior authorization processes including preparation of PA, answering Prior Authorization clinical questions, submitting Pharmacy benefit PA's
Utilize covermymeds to complete submission of Prior Authorizations
Communicate with providers and insurance companies regarding authorization status.
Maintain HIPAA compliance and support daily revenue cycle operations.
Aprima experience+
Skills & Qualifications
3-5 years rheumatology medication PA experience is Required
Specialty Pharmacy experience - Required
5+ years of prior authorization experience -Required
Knowledge of rheumatology medications and biosimilars -Required
Proficient in EMR systems, Covermymeds, ECW, NextGen Emrs
Strong communication, problem-solving, and organizational skills.
Detail-oriented, analytical, and able to multitask in a fast-paced environment.
Education & Experience
High School Diploma required; additional education in business or healthcare preferred.
Experience in prior authorization, utilization review, insurance verification, and EMR systems. [ preferred ]
Work Environment & Physical Requirements
Remote position
Prolonged computer use; ability to lift up to 15 lbs.
Job Type, Schedule & Compensation
Full-time, Monday–Friday, 8-hour day shift.
Pay: $21–$23 per hour , [ With additional pay available for exceptional experience .]
Apply for *New - Prior Authorization Specialist (Experience)- Remote at NYX Health, LLC