Pharmacy Prior Authorization Specialist

Prior Authorization SpecialistReports to: Pharmacy Prior Authorization ManagerJob Type: Full-Time – Remote – Pharmacies: West Virginia, Ohio, Indiana and MarylandPosition Overview: The Prior Authorization Specialist will maintain the Prior Authorization's workflow for a set of facilities assigned by the supervisor, while providing customer service to clients. He/she will enter required information and submit Prior Authorizations to the respective plan, follow the prior authorization to completion, identify and clarify any discrepancies with a prior authorization, and participate in the appeal process.Key Responsibilities Include but are not limited to:Work in cohesion with the Adjudication, Claim Intervention and Billing DepartmentsSubmit prior authorizations in accordance with Insurance regulationsEnsure accurate and timely processing of prior authorizationsWork directly with insurance companies for prior authorization resolutionCommunicate with facilities to gain additional informationAny other duties assignedFollow federal and state regulationsAdhere to company policies and proceduresFollow HIPPA guidelines and regulationsQualifications and Requirements:Prior Authorization experience (not required)Previous Long-Term Care pharmacy experience a plus (not required)Knowledge of Framework LTC a plus (not required)Salary and Benefits:Competitive salary commensurate with experienceComprehensive benefits package, including health, dental, and vision insurance, 401(k) with company match, paid time off, and more