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Medicare Prior Authorization and Appeals Representatives

About the Employer
  • A-Line Staffing Solutions
hourly Salary
$12.00 - $13.00

Job Description

Job Description

A-Line Staffing Solutions is Hiring Medicare Authorization and Appeals Representatives in San Antonio

**Position is REMOTE until Further Notice**

Position Summary:

Our client’s purpose is to help people on their path to better health. As a Medicare Pharmacy Authorizations and Appeals Analyst, you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. This is a great opportunity to initiate a career with a leading healthcare company by completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience. Are you looking for a new opportunity to work from home? This role will allow you to do so, 100% remotely.

In this role, you will be responsible for:

  • Utilizing multiple software systems to complete Medicare appeals case reviews
  • Meeting or exceeding government mandated timelines
  • Complying with turnaround time, productivity and quality standards
  • Conveying resolution to beneficiary or provider via direct communication and professional correspondence
  • Acquiring and maintaining basic knowledge of relevant and changing Med D guidance

SHIFT: 40 hours per week within operating hours of 7am – 8pm, Monday – Friday with a weekend rotation (every 4th weekend)

For immediate consideration, please send your resume to Michael Nichols at mnichols@alinestaffing.com

Required Qualifications:

  • Accountable and results driven
  • Critical thinker/problem solver
  • Receptive to constructive feedback and flexible in adapting to change
  • Ability to effectively plan, communicate, prioritize, and organize time and workload
  • Dedicated home work space needed, must have stable high speed internet, be able to provide a quiet uninterrupted work environment, must have workstation that is not accessible to common traffic and is secure from unintentional access.
  • Ability to execute successfully in a deadline-oriented, fast-paced, highly-regulated environment
  • Proficient in navigation of multiple computer applications
  • Proficient use of keyboard, mouse and ability to navigate 2 workstation monitors
  • Preferred Qualifications:
  • At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service
  • Six months of PBM/pharmaceutical related work strongly desired
  • Pharmacy Technician license preferred


  • High School Diploma or GED required
  • Bachelor’s degree in related field or equivalent work experience preferred

For immediate consideration, please send your resume to Michael Nichols at mnichols@alinestaffing.com



A-Line Staffing Solutions
Medicare Prior Authorization and Appeals Representatives

Tags: legal