Description Primary Responsibilities: + Sort and index incoming electronic fax transmittals into the appropriate Prior Authorization System (PAS) workbaskets. + Research and verify member, provider, and drug information using multiple systems. + Review incoming Prior Authorization (PA) faxes and initiate coverage determination requests within required SLAs. + Place outbound calls to providers and/or members to: + Gather additional information to complete PA cases. + Communicate outcomes of PA decisions. + 11:30am CST to 9:30pm CST Requirements Additional Responsibilities: + Navigate across various computer systems to support outbound communication needs. + Make outgoing calls to provide updates on PA outcomes, follow-ups, or to discuss processes (e.g., requirements, appeals). + Educate members, guardians, providers, and pharmacy staff to help prevent compliance issues. + Meet departmental performance expectations and complete tasks independently and on time. + Process prior authorization requests accurately across multiple platforms. + May handle inbound calls from members or providers, applying benefit plan criteria to make or recommend decisions. + Clarify and explain pharmaceutical benefits and authorization procedures. + Collaborate with team members to gather necessary information and interpret clinical guidelines. + Serve as a resource to support peers and team operations. TalentMatch® Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .