Prior Authorization Specialist – GLP-1 & Endocrinology (Remote)

About the role

We are looking for a highly organized Prior Authorization Specialist to manage high‑volume authorization requests for GLP‑1 medications and endocrine/diabetes treatments. The role is fully remote and requires strong attention to detail, excellent communication, and the ability to work efficiently in a fast‑paced healthcare environment.

Key responsibilities

• Process and manage at least 30 prior authorizations daily.
• Submit, monitor, and follow up on GLP‑1 and endocrine/diabetes authorization requests.
• Collaborate with providers, clinical staff, and healthcare teams to gather required documentation.
• Communicate approval, denial, and payer requirements clearly and professionally.
• Utilize payer portals, pharmacy benefit management systems, and electronic authorization platforms, including CoverMyMeds.
• Review payer‑specific guidelines to ensure complete and accurate submissions.
• Maintain detailed documentation of all activities and communications.
• Proactively address issues that could delay approvals and ensure compliance with regulations.

Required profile

• Prior authorization experience with major payers such as Anthem, UnitedHealthcare, Aetna, Optum, Express Scripts, Cigna, and Humana.
• Demonstrated success handling GLP‑1 medication authorizations.
• Experience with endocrinology or diabetes‑related prior authorizations.
• Hands‑on use of CoverMyMeds and other authorization tools.
• Excellent written and verbal communication skills.
• Strong critical‑thinking, problem‑solving, and organizational abilities.
• Self‑motivated, able to work independently in a high‑volume environment.

Required skills

• CoverMyMeds
• Payer portals
• Pharmacy benefit management systems
• Electronic authorization platforms