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
$20 - $24 per hour
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