Prior Authorization Specialist

Experience Required

None

Minimum Education Required

High School Diploma/G.E.D.

Compensation

$7.25 / hourly

Hours Per Week

40

Number Of Positions

1

Work Schedule and Shift Requirements

First (Day)

Job Description

Requisition: View phone number on click.appcast.io

Prior Authorization Specialist

Job Locations

US-KY-LOUISVILLE

ID View phone number on click.appcast.io Line of Business PharMerica Position Type Full-Time

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

Responsibilities

The Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with prescribers and or facility contact to have therapy changed to a preferred alternative due to insurance not covering the treatment in question

Essential Job 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

Qualifications

High School Diploma/General Education Diploma required

Kentucky Pharmacy Technician License preferred

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

About our Line of Business

PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit Follow us on Facebook, Twitter, and LinkedIn.

Res-Care, Inc., dba BrightSpring Health Services (“ResCare”), is an Equal Opportunity Employer. ResCare does not discriminate against any person on the basis of gender, r ace, color, national origin, r eligion, disability, age, veteran status, gender identity or s exual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.

Job Type

Full time

Benefits Offered

Not specified

Veteran Preference

No

Place of Work

On-site

Requisition ID

View phone number on click.appcast.io