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Prior Authorization Specialist

BrightSpring Health Services

Job Description

Job Description

Overview

This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow-up of prior authorizations. This role requires working knowledge of pharmacy benefits and the prior authorization process.

 

Schedule:
Monday - Friday 8 am-5:30 pm MST

 

We Offer:

• Competitive Pay 

• Health, Dental, Vision & Life Insurance

• Company-Paid Short & Long-Term Disability
• Flexible Schedules & Paid Time Off
• Tuition Reimbursement 
• Employee Discount Program & DailyPay
• 401k

• Pet Insurance

Responsibilities

  • Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply, ensuring compliance with payer requirements and clinical guidelines.
  • Collaborate with healthcare providers, insurance companies, and patients to gather necessary clinical information and documentation to support prior authorization submissions.
  • Submit prior authorization requests accurately and in a timely manner, utilizing electronic submission platforms and following established protocols.
  • Knowledgeable to perform all PA functions.

Qualifications

  • High School Diploma or GED or licensed/registered pharmacy technician or previous experience in Pharmacy
  • 1+ years pharmacy experience
  • Pharmacy or healthcare-related knowledge
  • Knowledge of pharmacy terminology including sig codes, and Roman numbers, brand/generic names of medication
  • Basic math and analytical skills
  • Intermediate typing/keyboard skills
Vacancy posted 1 day ago
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