Prior Authorization Specialist
About The Position
Our Company PharMerica Overview Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression! Mon-Fri(8:30am to 5pm) We offer: DailyPay Flexible schedules Competitive pay Shift differential Health, dental, vision and life insurance benefits Company paid STD and LTD Tuition Assistance Employee Discount Program 401k Paid-time off Tuition reimbursement Non-retail/Closed-door environment Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today! Position will be posted for a minimum of 7 business days
Requirements
- High School Diploma/General Education Diploma required
- Excellent customer service and communication skills, both written and verbal
- Ability to prioritize and meet pre-determined deadlines
- Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
- Experience in healthcare billing environment (pharmacy preferred)
- Familiarization with on-line claims processing and Medicaid and Medicare billing practices
- Proficient with Microsoft Word & Excel required
Nice To Haves
- Kentucky Pharmacy Technician License preferred
Responsibilities
- Ensure accurate and timely completion of client prior authorization and/or change of therapy paperwork by collaborating with prescribers and facility contacts
- Follows up on all claims requiring prior authorization within four to five business days
- Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of Pharmacy on weekly basis
- Compares system report of unbilled claims requiring prior approval to QuickBase tracking system to ensure any claim requiring prior authorization is being followed up on
- Assists Billing Department with resolving unbilled claims at each month end close
- Advocates for clients as needed
- Support for Pharmacy Operations
- Adjudicates and resolution of claim rejections as needed
- Utilizes Frameworks, QuickBase, Docutrack, and CoverMyMeds in order to complete workflow on daily basis
- Other responsibilities as assigned
Benefits
- DailyPay
- Flexible schedules
- Competitive pay
- Shift differential
- Health, dental, vision and life insurance benefits
- Company paid STD and LTD
- Tuition Assistance
- Employee Discount Program
- 401k
- Paid-time off
- Tuition reimbursement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
