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Pharmacy Prior Authorization Specialist
2 months ago
Tallahassee Memorial HealthCare is seeking a highly skilled Pharmacy Prior Authorization Specialist to join our team. As a Pharmacy Prior Authorization Specialist, you will play a critical role in ensuring that patients receive the necessary medications in a timely manner.
Key Responsibilities- Verify patient eligibility and obtain insurance benefits to ensure pre-certification, authorization, and referral requirements are met prior to medication delivery.
- Utilize a proactive approach to ensure timely approvals, facilitating high-quality patient care.
- Manage prior authorizations and support the 340B Drug Pricing Program.
- Maintain accurate and up-to-date documents and records.
- Audit documents to ensure regulatory compliance.
- Collaborate with healthcare providers, physicians, and clinical staff members to ensure seamless patient care.
- High school diploma or equivalent required; Associate degree in Healthcare Administration, Business Administration, or other Healthcare field preferred.
- Two (2) years of Healthcare, Medical Billing, or related experience required.
- Prior Authorization Certified Specialist (PACS) credential from the Accreditation Council for Medical Affairs (ACMA) within six (6) months post-hire.
- Certified Pharmacy Technician (CPhT) credential from the Pharmacy Technician Certification Board (PTCB) or the National Healthcareer Association (NHA) within six (6) months post-hire.
Tallahassee Memorial HealthCare is a private, nonprofit community-based healthcare system that provides advanced care to a 21-county region in North Florida and South Georgia. We are a career destination with nearly 6,000 colleagues who reflect the diversity of our community.
