PSS Claims & Authorization Specialist

Job overview

The PSS Claims & Authorization Specialist role is a full-time, in-office position in Brentwood, TN, paying $29 per hour. The role supports the Pharmacy Operations & Product Support Team at TruDataRx. The specialist executes prior authorization and pharmacy claim workflows, resolves complex escalations, and supports clinical reviews and communications. This work helps the team resolve member and provider concerns with accurate, compliant documentation.

What you'll do

• Manage prior authorization and appeals workflows in the Banjo platform
• enter, troubleshoot, and resolve pharmacy claim overrides in PBM systems
• support clinical case reviews and documentation gathering
• resolve escalated member and provider concerns
• coordinate outbound communications with prescribers, pharmacies, and members
• manage operational sub-projects, inventory tasks, or cross-functional tracking initiatives.

What we're looking for

Skills & competencies

pss claims & authorization specialist

brentwood tn

trudatarx

pharmacy operations

prior authorization

pbm claims

claims overrides

appeals

clinical team support

member and provider support

banjo platform

crm systems

high school diploma

$29 per hour

Work arrangement

• Weekend coverage required

Why this role

The posting requires at least one year of direct PBM operations experience, including exposure to medical necessity workflows or prior authorization case reviews; pharmacy technician experience or certification is preferred.

About the employer

TruDataRx Internal Careers is hiring for this role. Industry: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. Sector: 52.