Centralized Medication Prior Authorization Specialist; CMA or LPN

Overview

Medication Prior Authorization Specialist
Full-time position with benefits (40 hours per week). Daytime hours. The Medication Prior Authorization Specialist (Clinical) is responsible for obtaining timely prior authorizations for medications to ensure uninterrupted patient care. This role supports physicians, providers, and clinical team members in the Quad Cities by navigating insurance requirements and improving patient access to necessary medications.

• Area of Interest: LPN
• FTE/Hours per pay period: 1.0
• Department:
  Administration - Fort Dodge
• Shift: Monday - Friday 8A-4:30P
• Job

At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members. Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.

• Benefits examples include paid time off, parental leave, 401K matching, employee recognition, dental and health insurance, paid holidays, short and long-term disability, and more. We also offer pet insurance, daily pay, tuition reimbursement, and adoption assistance.

With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together. We believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience. Find a fulfilling career and make a difference with UnityPoint Health.

• Coordinate and process prior authorization requests for prescription medications and injections.
• Review clinical documentation to ensure completeness and compliance with payer requirements.
• Track and follow up on pending authorizations, ensuring timely approvals or appeals.
• Assist with appeals and denials, including gathering supporting documentation.
• Document all authorization activities within the Electronic Medical Record.
• Educate other team members in the clinic on payer-specific requirements and changes in authorization policies.
• Maintain up-to-date knowledge of insurance plans, formularies, and coverage criteria.
• Monitor and report on authorization trends and denials to support process improvement initiatives.
• Collaborate with clinical teams to ensure timely submission of accurate and complete prior authorization requests, minimizing delays in care.
• Conduct work as an extension of the clinical care team in support of excellent patient experience.
• Contribute to the development and maintenance of standard operating procedures related to prior authorization workflows.
• Establish effective mechanisms of communication with staff, physicians, advanced practice practitioners, and patients.
• Act as a liaison between providers, patients, insurance companies, and leadership in the realm of prior authorization expertise.
• Monitor clinical outcomes and patient satisfaction to ensure the highest level of care delivery.
• Collaborate with interdisciplinary teams to coordinate comprehensive care and continuously seek to improve the prior authorization process.

Education: Graduate of an accredited program for Medical Assistants. 3–5 years of experience as a Certified Medical Assistant will be considered as an alternative if the graduate is from a non-accredited program. Graduation from a registered Apprenticeship will also be considered as an alternative minimum requirement.

Licenses/Certifications: Current CMA certification for Certified Medical Assistant from AAMA, NCCT, AMT, or NHS.

• Specific offers are determined by factors such as experience and internal equity. The salary range listed does not include other forms of compensation which may include bonuses, differential pay, or other forms of compensation or benefits that may be applicable to this role.