Pharmacy Authorization Specialist - Drive Prior Auths

Prominence-Health-Plan; Reno (NV); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Challenging and rewarding work

Competitive Compensation & Generous PT

Excellent Medical, Dental, Vision and

401(K) with company match

SoFi Student Loan Refinancing Program

Career development opportunities

Job summary

Prominence Health is seeking a Pharmacy Authorization Specialist (Pharmacy Technician) to coordinate prior authorization reviews between members, providers, and the plan. You will load injectables PA requests, verify diagnoses, billing codes, and dosing; and perform outreach to obtain documentation for coverage determinations.

Applicants should understand medical drug billing, interpret clinic notes or drug orders, and support the pharmacy team to improve workflow and member/provider

Qualifications

• High School diploma or equivalent is required.
• Current and valid state licensure as a pharmacy technician is required.
• 3+ years in hospital or retail pharmacy preferred.
• Excellent English communication skills, written and verbal.
• Knowledge of medical terminology.
• Proficient in Microsoft Office.

Responsibilities

• Coordinate prior authorization reviews for injectable drugs.
• Load prior authorizations with correct diagnoses, billing codes, dose and frequency.
• Perform outreach to providers to obtain documentation for coverage determinations.

Skills

Customer service

Communication

Attention to detail

Analytical skills

Teamwork

Self-motivation

Education

High School diploma or equivalent

Current and valid state licensure as a pharmacy technician

Tools

Microsoft Office

Job description

Prominence Health is seeking a Pharmacy Authorization Specialist (Pharmacy Technician) to coordinate prior authorization reviews between members, providers, and the plan. You will load injectables PA requests, verify diagnoses, billing codes, and dosing; and perform outreach to obtain documentation for coverage determinations.

Applicants should understand medical drug billing, interpret clinic notes or drug orders, and support the pharmacy team to improve workflow and member/provider