Prior Authorization Specialist
About The Position
Our Company Pharmacy Alternatives 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! The ideal candidate has experience in healthcare billing environment (pharmacy preferred) and is familiar with on-line claims processing and Medicaid and Medicare billing practices. Schedule: Mon-Fri (8:30am to 5pm). This is not a remote opportunity. Applicants must reside in, or commutable distance, to Louisville, KY. A Hybrid schedule will be available after training: office on Wednesdays and home off on other days. 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. About our Line of Business Pharmacy Alternatives®, an affiliate of PharMerica, is a specialized pharmacy provider focused on serving individuals with cognitive or intellectual and developmental disabilities (I/DD). Pharmacy Alternatives offers long-term pharmacy solutions specializing in serving special-needs populations who live in intermediate care facilities, waiver homes, group homes, assisted living, supported-living or foster care. Our state-of-the-art approach includes packaging technology specially designed for the population we serve and electronic medication management that helps people live their best lives. For more information, please visit www.pharmacyalternatives.com. Follow us on Facebook and LinkedIn.
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
- 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
