Medication Access Specialist – Remote (up to $75/hr)

About the role

Mercor is seeking an experienced Medication Access Specialist to work remotely on a contract basis. You will support the authorization process for high‑cost specialty medications, ensuring timely access for patients across commercial, Medicare Part D, and Medicaid plans.

Key responsibilities

• Process and manage prior‑authorization requests for specialty drugs, biologics, and high‑cost pharmaceuticals.
• Review clinical documentation and pharmacy‑benefit criteria to confirm medical necessity.
• Evaluate AI‑generated prior‑authorization recommendations for accuracy, completeness, and payer compliance.
• Coordinate with prescribers, specialty pharmacies, and payers to secure authorizations.
• Handle appeals for denied requests, including peer‑to‑peer and exception processes.
• Annotate AI outputs and provide structured feedback to improve AI training datasets.

Required profile

• 5+ years of experience in pharmacy prior authorization, specialty medication access, or pharmacy benefit management.
• Deep knowledge of specialty drug formularies, step‑therapy protocols, and payer PA criteria for commercial and government payers.
• Familiarity with Medicare Part D coverage determination and exception processes.
• Excellent written and verbal English communication skills.
• High attention to detail when evaluating clinical documentation and AI outputs.

Required skills

• Experience with pharmacy benefit management (PBM) systems.
• Experience with specialty pharmacy platforms.
• Proficiency in using AI tools for pharmacy workflows.

What we offer

• Competitive hourly rate up to $75/hr.
• Fully remote work arrangement.
• Opportunity to contribute to AI‑enhanced pharmacy processes.