Authorization Specialist

Job Description

Job Description

7,000 Diseases - 500 Treatments - 1 Rare Pharmacy

PANTHERx is the nation’s largest rare disease pharmacy, and we put the patient experience at the top of everything that we do.

If you are looking for a career in the healthcare field that embraces authentic dedication to patient care, you don’t need to look beyond PANTHERx. In every line of service, in every position and area of expertise, PANTHERx associates are driven to provide the highest quality outcomes for our patients.

We are seeking team members who:

Are inspired and compassionate problem solvers;

Produce high quality work;

Thrive in the excitement of the ever-challenging environment of modern medicine; and

Are committed to achieving superior health outcomes for people living with rare and devastating diseases.

At PANTHERx, we know our employees are the driving force in what we do. We cultivate talent and encourage growth within PANTHERx so that our associates can continue to explore their interests and expand their careers. Guided by our mission to provide uncompromising quality every day, we continue our strategic growth to further reach those affected by rare diseases.

Join the PANTHERx team, and define your own RxARE future in healthcare!

Location: Pittsburgh, PA (Hybrid)

Classification: Non-Exempt

Status: Full-time

Reports to: Supervisor, Patient Access

Purpose

The Authorization Specialist initiates and/or follows up on prior authorizations in a timely manner. This role speaks with patients, health plans and/or physicians in the efforts to obtain authorization coverage for specialty medications.

Responsibilities

• Obtains prior authorization information from insurance carrier for active patients.
• Verifies patient eligibility and request/follow-up on prior authorization requests with health plans and physicians.
• Contacts patients as needed to provide authorization status for active referrals.
• Documents the prior authorization information in pharmacy systems.
• Assists with billing and reimbursement team projects as needed.
• Other duties as assigned by leadership.

Required Qualifications

• High school diploma or general education degree (GED).
• Strong written and verbal communication skills necessary to professionally and effectively convey ideas.
• Ability to multitask.
• Proficient with Excel and Word.

Preferred Qualifications

• One to two years of billing reimbursement or authorization follow-up.
• Experience or knowledge within the healthcare industry, particularly a mail order or specialty pharmacy.
• Experience with CPR+.
• Proficient with EDS billing systems.

Work Environment

This position operates in a home or professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

While performing the duties of this job, the employee is regularly required to sit, see, talk, or hear. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms. Visual acuity is necessary for tasks such as reading or working with various forms of data for extended periods on a computer screen. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of the job.

Benefits:

Hybrid, remote and flexible on-site work schedules are available, based on the position. PANTHERx Rare Pharmacy also affords an excellent benefit package, including but not limited to medical, dental, vision, health savings and flexible spending accounts, 401K with employer matching, employer-paid life insurance and short/long term disability coverage, and an Employee Assistance Program! Generous paid time off is also available to all full-time employees, as well as limited paid time off for part-time employees. Of course we offer paid holidays too!

Equal Opportunity:

PANTHERx Rare Pharmacy is an equal opportunity employer, and does not discriminate in recruiting, hiring, promotions or any term or condition of employment based on race, age, religion, gender, ethnicity, sexual orientation, gender identity, disability, protected veteran's status, or any other characteristic protected by federal, state or local laws.