Hybrid Authorization Specialist I: Pharmacy Reauthorizations

elevancehealth; Town of Florida (NY); Hybrid; USD 36,000 - 48,000; Full time

Job summary

BioPlus Specialty Pharmacy, part of Elevance Health, is seeking an Authorization Representative I to manage pharmacy prior authorizations across different therapy types. You will enter re-authorizations, submit to plans, log activities and follow up with insurers and physicians.

The role requires a HS diploma or GED and at least 1 year of prior authorization experience, with preferred certification as a Pharmacy Technician and familiarity with specialty pharmacy processes.

Qualifications

• HS diploma or GED and at least 1 year of experience processing pharmacy prior authorizations.
• Any combination of education and experience providing an equivalent background is acceptable.
• Preferred: Certified Pharmacy Technician, specialty pharmacy experience, medical terminology training, and experience with prior authorizations, denials and appeals.

Responsibilities

• 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.

Skills

Prior authorizations processing

Medical terminology familiarity

Phone/email follow-ups

Education

High School Diploma or GED

Certified Pharmacy Technician

Medical terminology training

Job description

BioPlus Specialty Pharmacy, part of Elevance Health, is seeking an Authorization Representative I to manage pharmacy prior authorizations across different therapy types. You will enter re-authorizations, submit to plans, log activities and follow up with insurers and physicians.

The role requires a HS diploma or GED and at least 1 year of prior authorization experience, with preferred certification as a Pharmacy Technician and familiarity with specialty pharmacy processes.