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Hawai'i Island Community Health Center

Prior Authorization Specialist

Entry-Level JobVerifiedNo experience needed

Career Insights for Medical Claims Processor / Representative

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Based on Hawaii data

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$57,239 / year median in Hawaii

-10% projected decline

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Job Description

Hawai'i Island Community Health Center Prior Authorization Specialist East or West Hawaiʻi Island | Full-Time Help patients access the medications they need. Make a difference every day. Hawaiʻi Island Community Health Center is seeking a compassionate, detail-oriented Prior Authorization Specialist to join our Clinical Pharmacy team. In this vital role, you will work closely with pharmacists, providers, insurance companies, specialty pharmacies, and patients to coordinate medication approvals and ensure timely access to prescribed therapies.
What You'll Do:
Submit and manage medication prior authorizations through insurance portals and electronic health record systems. Coordinate medication access for specialty and high-cost therapies. Collaborate with providers, pharmacists, infusion centers, and pharmacies to resolve coverage and reimbursement issues. Help patients navigate insurance requirements and medication access challenges. Support a patient-centered team committed to improving health outcomes across Hawaiʻi Island.
What We're Looking For:
✔ Strong organizational and communication skills ✔ Excellent customer service and problem-solving abilities ✔ Computer proficiency and attention to detail ✔ Pharmacy, insurance, or prior authorization experience preferred ✔ High School diploma or GED required ✔ Ability to obtain Hawaiʻi Pharmacy Technician registration within 90 days of hire Why Join HICHC? At HICHC, you'll be part of a mission-driven organization dedicated to providing accessible, quality healthcare to our island communities. Join a collaborative team where your work directly impacts patient care and wellbeing.