Pharmacy Prior Authorization Specialist
2 days ago
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
- 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
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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