Call Center Representative – Prior Authorization {169270}

Location: Franklin, TN (Hybrid – Onsite 3 days/week)
Pay Rate: $16.79/hour
Schedule: Monday – Friday, 8:00 AM – 5:00 PM (CT)
Work Type: Hybrid (must be onsite at least 3 days per week)
Worksite Address: 1021 Reams Fleming Blvd, Franklin, TN

We are seeking a detail-oriented and customer-focused Call Center Representative – Prior Authorization to support prior authorization and appeals processing. This role requires strong communication skills, the ability to manage multiple systems, and a solid understanding of prescription drug benefits and insurance processes.

• Process prior authorizations and appeals in accordance with program guidelines
• Document cases clearly, accurately, and in a timely manner
• Manage multiple cases simultaneously while maintaining attention to detail

• Handle inbound and outbound calls with professionalism
• Communicate effectively with patients, providers, agents, and internal teams
• Provide guidance on prescription benefits, coverage, and reimbursement processes
• Escalate issues as appropriate to ensure timely resolution

• Adhere to company policies and departmental program guidelines
• Maintain confidentiality and accuracy in all documentation
• Participate in cross-training to support multiple functions within the department
• Work independently while managing priorities in a fast-paced environment

• Understanding of benefit structures and reimbursement processes
• Familiarity with Medicare benefits, enrollments, and LIS assistance preferred

• Strong verbal and written communication skills
• Ability to clearly explain complex information to customers and stakeholders
• Professional phone etiquette and problem-solving skills

• Ability to manage multiple systems and cases simultaneously
• Strong documentation and time management skills
• Detail-oriented with the ability to thrive in a fast-paced environment

• High School Diploma or equivalent required
• Previous call center, healthcare, or insurance experience preferred
• Basic computer proficiency and ability to navigate multiple systems

• Ability to sit or stand for extended periods (7–10 hours per day)
• Occasional lifting up to 25 lbs
• Work performed in a climate-controlled, smoke-free office environment

• Safety-sensitive role
• Hybrid schedule with flexibility on in-office days
• Opportunity to grow within a dynamic, team-oriented environment

Qualified candidates are encouraged to apply for immediate consideration.