Pharmacy - Prior Authorization Specialist

3 weeks ago

Stanton, United States Beach Terrace Pharmacy Full time
Job DescriptionJob Description

We are seeking a Prior Authorization Specialist to became a part of our team You will assist in prior authorization request and coordinate with insurance carriers to ensure timely patient care.  

Responsibilities:

  • Get prior authorization approval from insurance companies and nurse managers
  • Appeal insurance companies after prior authorization refusal
  • Assess accounts for completeness and accuracy
  • Assist with providing necessary documentation to expedite approval and ensure the appropriate follow-up is performed
  • Document all prior authorization information in the patients profile

​Qualifications:

  • Knowledge on pulmonology, endocrinology, nephrology and ophthalmology medication
  • Knowledge on appeal process
  • Prior knowledge with CoverMyMeds
  • Understand insurance requirements and reimbursements
  • Strong analytical and critical thinking skills
  • Excellent written and verbal communication skills
  • Strong attention to detail
  • Strong organizational skills

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