Pharmacy Prior Authorization & Specialty-Medication Access Specialist

Job overview

The Pharmacy Prior Authorization & Specialty-Medication Access Specialist is remote. Compensation is $75 per hour. Mercor connects creative and technical talent with AI research labs. The specialist manages prior authorizations and access processes for specialty medications while evaluating AI-generated recommendations for accuracy and payer compliance. The role coordinates with prescribers, specialty pharmacies, and payers, handles appeals, and provides structured feedback to support AI training datasets.

What you'll do

• Process and manage prior authorization requests for specialty medications, biologics, and high-cost pharmaceuticals across commercial, Medicare Part D, and Medicaid payers
• review clinical documentation and benefit criteria
• evaluate AI-generated recommendations
• coordinate with prescribers, specialty pharmacies, and payers
• manage denied-authorization appeals, peer-to-peer requests, and exceptions
• annotate AI outputs and provide structured feedback.

What we're looking for

Skills & competencies

remote

mercor

pharmacy prior authorization

specialty medication access

specialty pharmacy

biologics

medicare part d

medicaid

appeals

ai evaluation

ai training data

$75/hr

Work arrangement

• Weekend coverage required

Why this role

Requires 5+ years of pharmacy prior authorization, specialty medication access, or pharmacy benefit management experience. CPhT or CPAP credentials are preferred; hub services, patient assistance programs, specialty pharmacy, infusion, oncology/rheumatology, and AI experience are also preferred.

About the employer

Mercor is hiring for this role. Industry: All Other Professional, Scientific, and Technical Services. Sector: 54.