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Authorization Specialist

1 month ago

Orlando, Florida, United States Specialty RX Full time
Authorization Representative Job Description

SpecialtyRx, a leading Long-Term Care pharmacy, is seeking an experienced Authorization Representative to join our Billing Department. As a key member of our team, you will play a crucial role in ensuring timely and accurate medication authorizations for our clients.

Responsibilities:
  • Evaluate medication orders and prescriptions from long-term care facilities to identify high-cost medications requiring authorization.
  • Liaise with facility staff to gather patient information and clinical documentation to support authorization requests.
  • Initiate and manage the authorization process for high-cost drugs, ensuring timely approval and communication with healthcare providers and payers.
  • Maintain accurate records of authorization requests, approvals, and denials to ensure compliance with regulatory guidelines and payer policies.
  • Provide guidance to facility staff on medication authorization procedures and requirements to ensure seamless communication and collaboration.
  • Stay updated on regulatory guidelines and payer policies related to high-cost drug authorizations to ensure compliance and optimal outcomes.
  • Communicate effectively with internal teams and external clients regarding authorization status and issues to ensure timely resolution and customer satisfaction.
  • Participate in training sessions and quality improvement initiatives to enhance authorization processes and ensure continuous improvement.
Qualifications:
  • Licensed Pharmacy Technician required.
  • Experienced in Long Term Care Pharmacy preferred.
  • Courteous and polite phone skills.
  • Computer literate.
  • Previous experience in Retail pharmacy a must.
  • Must be detail-oriented and able to multitask.

SpecialtyRx is an equal opportunity employer committed to diversity and inclusion. We welcome applications from qualified candidates who share our values and are passionate about delivering exceptional patient care and service.