(Remote – U.S., State Restrictions Apply)
🧾 About the Role
Navitus is looking for a Prior Authorization Specialist to support pharmacy benefit operations by reviewing and processing incoming medication requests from providers. This full-time remote role requires accuracy, strong communication, and a service-first mindset. Candidates must reside in eligible U.S. states (see below for exclusions).
✅ Position Highlights
• Role: Specialist I, Prior Authorization
• Location: Remote (U.S. only – exclusions apply)
• Department: Customer Service/Support
• Type: Full-Time
• Pay: $16.13 – $18.97 per hour
• Schedule: Varies (flexibility required)
• Company: Navitus Health Solutions
📋 What You’ll Own
• Process prior authorization requests via phone, fax, and web
• Troubleshoot claims and assist with provider inquiries
• Communicate criteria and drug formulary information to providers
• Support Medicare D, Medicaid, and Exchange plan operations
• Document interactions and follow HIPAA/privacy regulations
• Use downtime for professional development (eLearning, training, etc.)
• Participate in ad hoc projects across departments
• Maintain schedule and provide shift coverage when needed
🎯 Must-Have Traits
• High school diploma or GED required (post-secondary preferred)
• Customer service experience required
• Data entry, medical terminology, or pharmacy tech background preferred
• Experience in PBM, pharmacy, call center, or managed care a strong plus
• Familiarity with Medicare, Medicaid, or health insurance systems
• Comfort working across digital systems and platforms
• Professionalism, adaptability, and a service-oriented attitude
💻 Remote Requirements
• Must reside in the U.S.
• Not eligible for residents of: Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, or Wyoming
• Reliable internet and quiet, secure workspace
• Compliance with HIPAA and data protection guidelines required
💡 Why It’s a Win for Remote Job Seekers
Navitus offers a people-first pharmacy model that rejects the typical PBM status quo. You’ll be part of a diverse and mission-driven team that puts patients and providers at the center of healthcare decision-making.
🧾 Benefits Include
• Medical, dental, and vision insurance
• 20 PTO days + 9 paid holidays
• 4 weeks of paid parental leave
• 401(k) with up to 5% company match (immediate vesting)
• Adoption assistance + education & membership support
• Referral bonuses up to $750
• Flexible spending account
• #LI-Remote
✍️ Call to Action
If you’re ready to help reshape the pharmacy benefits world—one request at a time—apply now to join Navitus as a Prior Authorization Specialist. Accuracy, empathy, and purpose all come standard here.