Prior Authorization Specialist

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) 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 Non-retail/Closed-door environment 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 #J-18808-Ljbffr