Prior Authorization Coordinator

Arkansas Blue Cross Blue Shield • Little Rock, AR

3d • Onsite

About The Position

The Prior Authorization Coordinator coordinates the prior authorization process as well as assists with benefit and claims issues, provides analysis, reporting and documentation regarding pharmacy issues. Incumbent works closely with the internal pharmacy team, vendors, enterprise staff, pharmacies, providers and members to manage pharmacy benefits and assist with prior authorization requests.

Requirements

• Bachelor’s degree in related field. In lieu of degree, five (5) years' pharmacy or healthcare operations experience will be considered.
• Minimum three (3) years' pharmacy operations experience, preferably handling prior authorization requests and pharmacy issues.
• Knowledge of prior authorization requests, pharmacy operations, pharmacy benefits management, healthcare delivery, healthcare insurance, medical and/or pharmacy claims.
• Pharmacy Operations
• Prior Authorizations
• Analyze Information
• Balance Priorities
• Microsoft Access
• Microsoft PowerPoint
• Microsoft Word
• Microsoft Excel
• Oral & Written Communication
• Interpersonal Communication
• Professional Judgment
• Highly Organized
• Ability to work independently or with a team.
• Active Listening
• Analytical Problem Solving
• Business Compliance
• Collaborative Communications
• Critical Thinking
• Cross-Functional Communications
• Customer Relationship Management (CRM)
• Customer Service Workstation
• Data Analysis
• Data Management
• Health Insurance Portability & Accountability Act (HIPAA)
• Medical Prescriptions
• Microsoft Access
• Microsoft Excel
• Microsoft PowerPoint
• Microsoft Word
• Oral Communications
• Pharmacy
• Problem Sensitivity
• Security Awareness
• Written Communication

Responsibilities

• Administrators the prior authorization process and provides necessary correspondence, documentation, analysis and reporting to providers, members, pharmacy, or vendors for decision making and resolution of prior authorization requests, inquires and complaints
• Assists with testing of new system benefit setup and maintain up-to-date procedural documentation
• Performs other duties as assigned
• Provides assistance with escalated issues and questions to internal team, external vendors, providers and pharmacies; and analyzes, identifies and researches benefit issues and questions for correction and resolution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level