Biologics & Medication Prior Authorization Specialist

ADP, Inc.; Dahlonega (GA); On-site; USD 48,712,000 - 68,770,000; Full time

Benefits offered by this job

Paid Time Off (PTO)

Medical Insurance

Vision Insurance

Life Insurance

Aflac Supplemental Insurance

401(k) Retirement Plan

Supportive team environment

Job summary

Cleaver Dermatology & Aesthetics is seeking a detail-oriented Biologics & Medication Prior Authorization Specialist to join our Dermatology team, managing prior authorizations for dermatology meds, including biologics and specialty therapies.

The ideal candidate is highly organized, communicates effectively with patients, pharmacies, providers and insurers, and will take ownership of the authorization process from start to finish to ensure timely access to medications.

Qualifications

• Previous experience with prior authorizations, medication authorizations, specialty medications, or insurance verification preferred
• Dermatology experience is a plus
• Experience working with biologics is highly preferred
• Strong understanding of health insurance processes and terminology

Responsibilities

• Manage prior authorizations for dermatology medications, including biologics, specialty medications, and other prescription therapies
• Submit and process medication prior authorizations through insurance portals, electronic systems, and other required platforms
• Review insurance requirements and determine necessary documentation for medication approvals
• Gather supporting clinical documentation, including office notes, diagnosis information, previous treatments, medication history, and treatment failures
• Communicate with providers and clinical staff regarding prior authorization requirements and necessary documentation
• Track pending, approved, denied, and appealed prior authorizations

Skills

Prior authorizations

Medication authorizations

Insurance verification

Dermatology experience

Biologics experience

EMR experience

Job description

Cleaver Dermatology & Aesthetics is seeking a detail-oriented Biologics & Medication Prior Authorization Specialist to join our Dermatology team, managing prior authorizations for dermatology meds, including biologics and specialty therapies.

The ideal candidate is highly organized, communicates effectively with patients, pharmacies, providers and insurers, and will take ownership of the authorization process from start to finish to ensure timely access to medications.