Pharmacy Prior Authorization Specialist

2 days ago


Louisville, Kentucky, United States Southern Home Care Services, Inc. Full time
Job Title: Prior Authorization Coordinator

We are seeking a highly skilled Prior Authorization Coordinator to join our team at PharMerica. As a Prior Authorization Coordinator, you will play a critical role in ensuring that our clients receive the necessary pharmacy services in a timely and efficient manner.

Responsibilities:
  • Ensure accurate and timely completion of client prior authorization and/or change of therapy paperwork by collaborating with prescribers and facility contacts
  • Follows up on all claims requiring prior authorization within four to five business days
  • Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of Pharmacy on weekly basis
  • Compares system report of unbilled claims requiring prior approval to QuickBase tracking system to ensure any claim requiring prior authorization is being followed up on
  • Assists Billing Department with resolving unbilled claims at each month end close
  • Advocates for clients as needed
  • Support for Pharmacy Operations
  • Adjudicates and resolution of claim rejections as needed
Requirements:
  • High School Diploma/General Education Diploma required
  • Kentucky Pharmacy Technician License preferred
  • Excellent customer service and communication skills, both written and verbal
  • Ability to prioritize and meet pre-determined deadlines
  • Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
  • Experience in healthcare billing environment (pharmacy preferred)
  • Familiarization with on-line claims processing and Medicaid and Medicare billing practices
  • Proficient with Microsoft Word & Excel required
About PharMerica:

PharMerica is a full-service pharmacy solution providing value beyond medication. We are the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations.

We offer a non-retail pharmacy environment with a hybrid schedule, Monday-Friday from 8:30am - 5pm Central Time. This role is based out of Louisville, KY and after training, will become a hybrid schedule with time spent in the office as well as your home office.

We offer a competitive pay, flexible schedules, daily pay, health, dental, vision and life insurance benefits, company paid STD and LTD, tuition assistance, employee discount program, 401k, paid-time off, tuition reimbursement, and non-retail/Closed-door environment.



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