Authorization Representative I - BioPlus Specialty Pharmacy

Elevance Health (Anthem); St. Louis (MO); Híbrido; USD 42.000 - 58.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health, dental, vision insurance

401(k) with company match

Paid holidays and PTO

In-office 1–2 days per week hybridwork

Descripción de la vacante

Elevance Health's BioPlus Specialty Pharmacy is hiring an Authorization Representative I to handle re-authorizations for patients with health plan requirements. The role combines in-office collaboration 1–2 days weekly with flexible, supportive remote work, within a hybrid framework.

The ideal candidate will have a HS diploma/GED and at least 1 year of prior authorization experience, with Certified Pharmacy Technician credentials highly preferred.

Formación

• Requires HS diploma or GED and 1 year of experience processing pharmacy prior authorizations.
• Certified Pharmacy Technician highly desired.
• Experience with Prior Authorizations, Denials and Appeals is highly desired.

Responsabilidades

• Enters re-authorizations into the portal and ensures accurate completion of re-authorization forms.
• Submits completed re-authorization forms to insurance plans.
• Maintains log of all re-authorizations submitted.
• Follows up with insurance companies or physicians' offices on submitted re-authorizations.

Conocimientos

Pharmacy terminology

Prior authorizations

Communication skills

Educación

HS diploma or GED

Herramientas

Pharmacy portal

Descripción del empleo

Anticipated End Date:

2026-10-19

Position Title:

Authorization Representative I - BioPlus Specialty Pharmacy

Job Description:

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.

Job Level: Non-Management Non-Exempt

Workshift: 1st Shift (United States of America)

Job Family: CUS > Care Support

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.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

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, n