Prior Authorization Specialist

4 weeks ago


Englewood, United States ResCare Full time

Our Company Amerita Overview Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. As one of the most respected Specialty Infusion providers in America, we service thousands of patients nationwide through our growing network of branches and healthcare professionals. ThePrior Authorization Specialist role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. NOTE: Work Schedule: Monday - Friday / 9:00am - 5:30pm * Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts Supplemental Coverage - Accident, Critical Illness and Hospital Indemnity Insurance 401(k) Retirement Plan with Employer Match Company paid Life and AD&D Insurance, Short-Term and Long-Term Disability Employee Discounts Tuition Reimbursement Paid Time Off & Holidays Responsibilities * Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply, ensuring compliance with payer requirements and clinical guidelines. * Collaborate with healthcare providers, insurance companies, and patients to gather necessary clinical information and documentation to support prior authorization submissions. * Submit prior authorization requests accurately and in a timely manner, utilizing electronic submission platforms and following established protocols. * Knowledgeable to perform all PA functions. Qualifications * High School Diploma or GED or licensed/registered pharmacy technician or previous experience in Pharmacy * 1+ years pharmacy experience * Pharmacy or healthcare-related knowledge * Knowledge of pharmacy terminology including sig codes, and Roman numbers, brand/generic names of medication * Basic math and analytical skills * Intermediate typing/keyboard skills About our Line of Business Amerita is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness and entrepreneurial spirit of a local provider. For more information about Amerita, please visit www.ameritaiv.com. Follow us on Twitter and LinkedIn. Salary Range USD $18.50 - $28.00 / Hour

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