Admissions & Prior Authorization Lead (Hybrid)

Orsini Healthcare; Elk Grove Village (IL); Hybrid; USD 60,000 - 65,000; Full time

Benefits offered by this job

Medical Coverage, Dental, and Vision

401(k) with employer match

Accident and Critical Illness coverage

Company-paid life insurance options

Generous PTO and holidays

Tuition reimbursement

Job summary

Orsini Rare Disease Pharmacy Solutions seeks a Supervisory Leader to oversee a team of Prior Authorization Representatives, handling data-entry for enrollments and processing of claims. You will ensure accuracy, drive performance, and assist with staffing and training to support growth.

The role requires leadership, expertise in major medical insurance, and pharmacy terminology knowledge. Hybrid work at Elk Grove Village and coordination with multiple departments are key aspects of this position.

Qualifications

• Leadership experience managing a team
• Experience with Major Medical Insurance
• Pharmacy Technician License is required
• National Technician Certification preferred
• Knowledge of pharmacy benefits and claims processing
• Familiarity with HCPCS codes and insurance terminology
• Ability to multitask in a fast-paced environment
• Attention to detail and strong communication skills
• Ability to work collaboratively with diverse teams

Responsibilities

• Oversee data-entry for new enrollments and Prior Authorization processing
• Provide oversight for claims processing and resolution of rejected medical/pharmacy claims
• Assist with hiring, training and motivating staff
• Ensure HIPAA compliance and adherence to department policies
• Develop policies, process improvements, and cross-department communication
• Manage integration of new Specialty therapies and information dissemination
• Escalate IT issues and coordinate with other departments as needed

Skills

Leadership

Major Medical Insurance

Pharmacy Technician License

National Technician Certification

Pharmacy benefit knowledge

Insurance terminology knowledge

HCPCS codes

Multitasking

Detail oriented

Verbal/written communication

Collaborative teamwork

Diversity awareness

Education

Pharmacy Technician License – required

National Technician Certification – preferred

Job description

Orsini Rare Disease Pharmacy Solutions seeks a Supervisory Leader to oversee a team of Prior Authorization Representatives, handling data-entry for enrollments and processing of claims. You will ensure accuracy, drive performance, and assist with staffing and training to support growth.

The role requires leadership, expertise in major medical insurance, and pharmacy terminology knowledge. Hybrid work at Elk Grove Village and coordination with multiple departments are key aspects of this position.