Pharmacy Prior Authorization Specialist - Claims & Billing

Pharmacy Alternatives

Louisville (KY)

On-site

USD 42,000 - 54,000

Full time

14 days+

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Benefits offered by this job

DailyPay

Flexible schedules

Competitive pay

Shift differential

Health, dental, vision and life保险

Company paid STD and LTD

Tuition Assistance

Employee Discount Program

401k

Paid-time off

Tuition reimbursement

Job summary

Pharmacy Alternatives, an affiliate of PharMerica, is seeking a detail-oriented Prior Authorization Coordinator for a non-retail, closed-door pharmacy serving long-term care and senior living clients in Louisville, KY. The role focuses on timely PA processing, claims tracking, and collaboration with prescribers and facilities.

The ideal candidate has healthcare billing experience, familiarity with online claims, and strong Excel/Word skills.

Qualifications

High School Diploma or GED is required.
Pharmacy Technician license (Kentucky) preferred.
Excellent customer service and communication skills, written and verbal.
Ability to prioritize and meet deadlines.
Proficient with Microsoft Word and Excel.
Experience in healthcare billing and online claims processing (Medicaid/Medicare) preferred.

Responsibilities

Complete client prior authorization and therapy change paperwork with prescribers and facility contacts.
Follow up on all claims requiring prior authorization within 4–5 business days.
Track claims in QuickBase and report to Director of Pharmacy weekly.
Review unbilled claims requiring prior authorization and ensure follow-up.
Assist Billing Department with unbilled claims at month-end close.
Adjudicate claim rejections and support Pharmacy Operations.