Job Description
Evernow is a healthcare organization seeking a Prior Authorization Processor to support insurance prior authorization submissions for hormone therapy and weight management medications.
This role is focused on accurate, timely execution of prior authorization submissions using established templates, criteria, and workflows. We are looking for someone who has real prior authorization experience, understands payer portals, and can manage submissions and follow-ups reliably, without requiring extensive oversight.
Success in this role comes from attention to detail, consistency, and knowing when to escalate issues appropriately.
Key Responsibilities:
-Submit prior authorizations for prescription medications using provided templates and criteria
-Enter clinical and insurance documentation accurately into payer portals
-Track PA submissions, statuses, and responses
-Follow up with insurance plans as needed to ensure timely resolution
-Identify denials or requests for additional information and escalate per defined workflow
-Maintain organized records of PA activity and outcomes
-Communicate clearly with internal team members regarding PA status and next steps
To ensure clarity, this role does not include:
-Peer-to-peer coordination with payers
-Making clinical judgment calls
Required Experience & Skills:
-Prior hands-on experience submitting insurance prior authorizations
-Familiarity with payer portals and PA workflows
-Strong attention to detail and ability to follow standardized processes
-Basic understanding of medical documentation and insurance requirements
-Ability to manage multiple submissions and track status effectively
-Comfortable working independently in a remote environment
-Experience with hormone therapy or weight loss medications is strongly preferred but not required.
Please note: only applications submitted through Upwork will be considered.
Do NOT contact us directly — all off-platform outreach will be ignored.
To apply, please include:
Your résumé with a short introduction
A brief Loom Video introducing yourself
Your weekly availability and timezone