Authorization Representative I - BioPlus Specialty Pharmacy

Elevance Health; St. Louis (MO); Hybrid; USD 38,000 - 60,000; Full time

Benefits offered by this job

merit increases

paid holidays

Paid Time Off

incentive bonus programs (unless cared

medical

dental

vision

short-term disability benefits

long-term disability benefits

401(k)+match

stock purchase plan

life insurance

wellness programs

financial education resources

Job summary

Elevance Health's BioPlus Specialty Pharmacy is seeking an Authorization Representative I to manage drug re-authorizations and submit forms to insurance plans. The role combines in-office collaboration 1-2 days weekly with flexible hybrid work, and requires strong attention to detail.

You will maintain logs, follow up on approvals, and support patients and providers through the authorization process, contributing to efficient prior authorization workflows.

Qualifications

• HS diploma or GED required or equivalent.
• Certified Pharmacy Technician certification is highly desirable.
• Experience with specialty pharmacy and prior authorizations preferred.
• Medical terminology training is a plus.

Responsibilities

• Enters re-authorizations into the portal with accurate details.
• Submits re-authorization forms to insurance plans.
• Maintains a log of all submitted re-authorizations.
• Follows up with insurers and physicians to verify status.

Skills

Certified Pharmacy Technician

Specialty pharmacy experience

Medical terminology

Prior Authorizations/ Appeals

Education

HS diploma or GED

Job description

Authorization Representative I – BioPlus Specialty Pharmacy

Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

BioPlus Specialty Pharmacy is a proud member of the Elevance Health family of companies. BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

The Authorization Representative I will be responsible for the completion and submission of appropriate forms for patients whose health plan requires drug re-authorizations for different therapy types.

How You Will Make An Impact

• Enters re-authorizations into the portal and ensures accurate completion of re-authorization forms.
• Submits completed re-authorization forms to the appropriate insurance plans.
• Maintains log of all re-authorizations submitted.
• Follows up with the patient's insurance company or physician office by phone, email or spreadsheets on all submitted re-authorization for patient approval/denial status.

Minimum Requirements

• Requires a HS diploma or GED and a minimum of 1 year of experience processing pharmacy prior authorizations; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities And Experiences

• Certified Pharmacy Technician highly desired.
• Specialty pharmacy experience highly preferred.
• Medical terminology training is preferred.
• Experience with Prior Authorizations, Denials and Appeals highly desired.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs (unless covered by a collective bargaining agreement)
• medical
• dental
• vision
• short-term disability benefits
• long-term disability benefits
• 401(k)+match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.