Prior Authorization Specialist

Overview 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 those looking for career progression. Work Hours Mon‑Fri: 8:30 am – 5:00 pm. Benefits DailyPay Flexible schedules Competitive pay and shift differential Health, dental, vision, and life insurance benefits Company‑paid STD and LTD Tuition assistance / reimbursement Employee discount program 401(k) Paid‑time off Position Posting Position will be posted for a minimum of 7 business days. Responsibilities The Prior Authorization Coordinator is responsible for completing approvals for pharmacy claims requiring prior authorization, or coordinating with prescribers and facility contacts to have therapy changed to a preferred alternative when insurance does not cover the treatment. 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. Follow up on all claims requiring prior authorization within four to five business days. Track and review all claims in QuickBase and send an Excel tracking spreadsheet to the Director of Pharmacy weekly. Compare system reports of unbilled claims requiring prior approval to QuickBase tracking to ensure all required authorizations are followed up. Assist the Billing Department with resolving unbilled claims at each month‑end close. Advocate for clients as needed. Support Pharmacy Operations. Adjudicate and resolve claim rejections as needed. Utilize Frameworks, QuickBase, Docutrack, and CoverMyMeds to complete daily workflow. Perform other responsibilities as assigned. Qualifications High School Diploma or General Education Diploma required. Kentucky Pharmacy Technician License preferred. Excellent customer service and communication skills, both written and verbal. Ability to prioritize and meet predetermined deadlines. Must be able to effectively multi‑task, be proficient at typing, and have advanced technical skills. Experience in a healthcare billing environment (pharmacy preferred). Familiarity with online claims processing and Medicaid and Medicare billing practices. Proficiency with Microsoft Word and Excel required. #J-18808-Ljbffr PharMerica