Prior Authorization Specialist

1 month ago


Lafayette, United States Professional Arts Specialty Pharmacy Full time
Job DescriptionJob Description

Our goal is to solve patients’ complex prescription needs to improve their quality of life. As one of the first points of contact, Prior Authorization Specialists fill an important role establishing a caring relationship with our new patients. They help us to go above and beyond to ensure that customers feel supported throughout the prescription fulfillment process.

Professional Arts Pharmacy has proven to be an advocate for patient access to compounded and specialty drugs. The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third-party authorization requests.

Responsibilities and Duties

  • Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
  • Follow prior authorization workflow and policies and procedures.
  • Collaborate with other departments to assist in obtaining prior authorizations.
  • Review accuracy and completeness of information requested and ensure that all supporting documents are present.
  • Receive requests for prior authorizations and ensure that they are properly and closely monitored.
  • Process referrals and submit clinical supporting documentation to insurance carriers to expedite prior authorization processes.
  • Manage correspondence with insurance companies, physicians and patients as required.
  • Look through denials and submit appeals if requested by physician to get them approved from insurance companies.
  • Document all prior authorization information including approval dates, prior authorization number in patient profile.
  • Proactively work on prior authorizations that are due to be expired.
  • Secure patients’ demographics and medical information by using great discretion and ensuring that all procedures are in sync with HIPAA compliance and regulations.

Qualifications

  • High school diploma or GED equivalent required.
  • No pending felony charges or convictions for criminal offenses involving controlled substances.
  • Previous Experience in Pharmacy or Medical office with Prior Authorizations desired

Skills

  • Handling patient information with accuracy and confidentiality.
  • Excellent time management skills and ability to multi-task, prioritize work and meet deadlines.
  • Attention to detail and problem-solving skills.
  • Excellent written and verbal communication skills.
  • Strong organizational and planning skills.
  • Ability to work well in a team environment and independently.
  • Knowledge of medical terminology (including sig codes and Roman numeral), brand and generic names of medications and general pharmacy terminology is preferred
  • Intermediate typing/keyboarding skills
  • Good interpersonal skills




  • Lafayette, United States Acadiana Retina Consultants Full time

    Job DescriptionJob DescriptionAre you a fixer? Our thriving ophthalmology practice has a new position available for an organized, detail oriented individual to join our insurance team. We are looking for a motivated, self starter with a thorough understanding of the medical claims process. Previous medical claims experience is required. Starting pay of...


  • Lafayette, United States Indiana University Health Full time

    Job Description This position is responsible for the delivery of customer facing services within Revenue Cycle System Services. Responsibilities may include, but are not limited to, scheduling, registration, insurance verification, prior-authorization, financial counseling/individual solutions, cashiering, release of information and customer service....


  • Lafayette, United States CARDIOLOGY SPECIALISTS OF ACADIANA, LLC Full time

    Reports to: RevenueCycle Manager Position Summary Obtains prior authorization on allscheduled diagnostic testing and procedures ordered by group physicians, bothin office and off-site, as required by insurance to secure payment. Documents appointmentschedule and EMR in effective and detailed manner. Job Responsibilities • Maintainsa current knowledge of...

  • ATAC Specialist

    2 weeks ago


    Lafayette, United States Acadian Ambulance Service Full time

    Acadian Ambulance has an immediate opening for an ATAC Specialist inLafayette, LA. This position is eligible for a hybrid work schedule after completing the required office based training period. The selected individual will work a 12-hour shift (to be determined) on a 2-2-3 schedule (2 days on, 2 days off, 3 days on for the first week of a pay period and 2...


  • Lafayette, United States Acadiana Retina Consultants Full time

    Job DescriptionJob DescriptionAre you a fixer? Our thriving ophthalmology practice has a new position available for an organized, detail oriented individual to join our insurance team. We are looking for a motivated, self starter with a thorough understanding of the medical claims process. Previous medical claims experience is required. Starting pay of...

  • Intake Specialist

    3 weeks ago


    Lafayette, Louisiana, United States Advantage Resourcing Full time

    Advantage Resourcing is recruiting for an Intake Specialist for a medical company in the Lafayette area. Join a rapidly growing company and become part of a dynamic team dedicated to providing excellent patient care. Schedule: Monday-Friday, 8 am-5 pm Pay Rate: $16/hr The Intake Specialist is responsible for gathering patient demographic and insurance...

  • Intake Specialist

    3 weeks ago


    Lafayette, United States Advantage Resourcing Full time

    Advance your career with Advantage Resourcing as we recruit for an Intake Specialist position with a prominent medical company in Lafayette. Embrace the opportunity to join a rapidly expanding organization dedicated to delivering exceptional patient care. Apply today and seize the chance to contribute to a dynamic team committed to excellence. Schedule:...

  • Intake Specialist

    1 week ago


    Lafayette, United States Advantage Resourcing Full time

    Advantage Resourcing is looking for new talent in Lafayette, LA! We are hiring an Intake Specialist to join a dedicated team delivering personalized healthcare. Our client, the nation's leader in home disease management, provides top-notch respiratory services in patients' homes. If you have 1-2 years of experience working with a Durable Medical Equipment...


  • Lafayette, United States Advantage Resourcing Full time

    Do you have one year of insurance verification experience and a passion for helping others? Advantage Resourcing has partnered with a leading healthcare equipment company in Lafayette, LA, to find a talented Insurance Change Specialist. Join a team of dedicated professionals who value inclusivity and support and help us continue to provide exceptional...

  • Placement Specialist

    3 weeks ago


    Lafayette, Louisiana, United States Clark Insurance Full time

    Company Marsh McLennan Agency Description Position Title: Placement Specialist FLSA Status: Exempt Position Summary: The Placement Specialist leads the marketing process for Business Insurance renewals. Qualified candidates can be based anywhere in Louisiana. We have offices in Metairie, Mandeville, Baton Rouge, Lafayette, Lake Charles, and Shreveport. We...

  • Lube Specialist

    4 weeks ago


    Lafayette, United States Bilfinger Full time

    **Lube Specialist** Location: Lafayette, Indiana Bilfinger, Inc. is a leading international services contractor with a proven track record in providing integrated, multi-disciplined support services and maintenance solutions to international blue-chip clients, primarily in the energy, petrochemical, industrial, and utilities sector. We are currently...


  • Lafayette, United States Acadia Healthcare Full time

    Admissions Specialist LPN BENEFITS: Vermilion Behavioral Health Systems provides a comprehensive benefits package.Current benefits include: •Competitive hourly rate with shift differential available •Medical, dental, and vision insurance •Acadia Healthcare 401(k) plan •Excellent training program •Professional growth opportunity that is second to...

  • Lube Specialist

    3 weeks ago


    Lafayette, Louisiana, United States Bilfinger Full time

    Lube SpecialistLocation: Lafayette, IndianaBilfinger, Inc. is a leading international services contractor with a proven track record in providing integrated, multi-disciplined support services and maintenance solutions to international blue-chip clients, primarily in the energy, petrochemical, industrial, and utilities sector. We are currently recruiting for...


  • Lafayette, United States SCL Health Full time

    Job DescriptionWe are offering a $1,000 SIgn on Bonus for this position as well as additional differentials You.You bring your body, mind, heart and spirit to your work as a Patient Access Associate I / Registration Specialist - Float ( Brighton, Lafayette, Wheat Ridge)You know how to move fast. You know how to stay organized. You know how to have fun.You're...


  • Lafayette, United States Acadiana Retina Consultants Full time

    Job DescriptionJob DescriptionAre you a fixer? Our thriving ophthalmology practice has a new position available for an organized, detail oriented individual to join our insurance team. We are looking for a motivated, self starter with a thorough understanding of the medical claims process. Previous medical claims experience is required. Starting pay of...

  • Lube Specialist

    1 month ago


    Lafayette, United States Bilfinger Full time

    Lube Specialist   Location: Lafayette , Indiana   Bilfinger is a leading international industrial services provider, active primarily in Continental Europe, Northwest Europe, North America, and the Middle East. With over 4, skilled employees in North America, Bilfinger delivers its services across multiple industries that include...


  • Lafayette, Louisiana, United States Mobilelink Full time

    Job DetailsJob Location NewOrleans, LA Position Type Full Time Salary Range $ $16.00 Base+Commission/month Job Category Store Sales DescriptionPerks of being on a Team Unlimited earning potential Unlimited growth potential PTO after 90 days. Dental Insurance Health insurance Vision insurance Company-paid Life Insurance With over 500 Cricket stores,...


  • Lafayette, United States SCL Health Full time

    Job Description:Responsible for registering patients in multiple service lines all necessary demographic, financial, and clinical information from the patient or representative. Scope This is a Full time Position. Shifts are M-F As a Patient Access Associate I / Registration Specialist, you need to know how to: Register patients. Confirm, enter, and/or...


  • Lafayette, United States LHC Group Full time

    Job DescriptionWe are hiring for a Financial Intake Specialist. At LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve-it truly is all about helping people. We strive to offer benefits that reward the whole you!...

  • Training Specialist

    1 month ago


    Lafayette, United States Aegis Worldwide Full time

    Job DescriptionJob DescriptionRole Overview: As a Training Specialist, you will play a crucial role in ensuring that our workforce is equipped with the necessary knowledge and skills to excel in their roles. You will be responsible for developing and implementing training programs tailored to the specific needs of our manufacturing environment. Your efforts...