Pharmacy Prior Authorization and Billing Specialist
ProMedica•Toledo, OH
•Onsite
About The Position
As a Pharmacy Prior Authorization and Billing Specialist, you will perform prior authorizations for medications through medical or pharmacy benefits as determined by the medication and payer. The role involves collaborating and communicating with providers and pharmacies to provide timely resolution of authorizations and denials. Additionally, you may assist in securing patient financial assistance for patients who are under-insured or uninsured.
Requirements
- Associate degree in related field OR Certified Pharmacy Tech OR 5 years of Billing/Insurance Verification experience
- Familiarity with ICD-10 and CPT codes applicable to services rendered
- 5 years of relatable experience in a medical office, retail pharmacy, drug claims processing, or revenue cycle
Nice To Haves
- Specific knowledge of medication prior authorization
Responsibilities
- Perform prior authorizations for medications through medical or pharmacy benefits as determined by the medication and payer
- Collaborate and communicate with providers and pharmacies to provide timely resolution of authorizations and denials
- Assist in securing patient financial assistance for patients who are under-insured or uninsured
Benefits
- Flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
