Pharmacy Prior Authorization & Billing Expert

ProMedica; Toledo (OH); On-site; USD 42,000 - 56,000; Full time

Job summary

ProMedica is seeking a Pharmacy Prior Authorization and Billing Specialist in Toledo for the Pharmacy department. The role involves handling prior authorizations for medications through medical or pharmacy benefits, and collaborating with providers and pharmacies to resolve authorizations and denials.

The position requires an Associate degree or Certified Pharmacy Technician credential, plus extensive experience in billing/revenue cycle, ICD-10, and CPT coding.

Qualifications

• Associate degree or certified pharmacy technician credential, with relevant healthcare billing experience.
• Experience with ICD-10 and CPT coding for services.
• Minimum 5 years in medical office, retail pharmacy, or revenue cycle related roles.

Responsibilities

• Process medication prior authorizations for medical or pharmacy benefits.
• Communicate with providers and pharmacies to resolve authorizations and denials.
• Assist patients without adequate coverage with financial assistance options.

Skills

Billing/Insurance Verification

ICD-10 and CPT codes

Pharmacy Technician Certification

Education

Associate degree in related field

Job description

ProMedica is seeking a Pharmacy Prior Authorization and Billing Specialist in Toledo for the Pharmacy department. The role involves handling prior authorizations for medications through medical or pharmacy benefits, and collaborating with providers and pharmacies to resolve authorizations and denials.

The position requires an Associate degree or Certified Pharmacy Technician credential, plus extensive experience in billing/revenue cycle, ICD-10, and CPT coding.