Prior Authorization & Appeals Specialist

Hy-Vee, Inc.; Omaha (NE); Presencial; USD 26 000 - 28 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Six paid holidays

Resumo da oferta

Amber Specialty Pharmacy is seeking a Dedicated Authorization Management Specialist to handle prior authorizations and appeals for a designated product program. You will liaise with prescribers, health plans, PBMs, and patients to secure timely approvals and maintain accurate documentation.

The role is office-based in a healthcare setting, requiring HIPAA awareness, strong Excel/Outlook skills, and ability to meet strict deadlines while delivering excellent customer service.

Qualificações

• High school diploma or equivalent.
• Six months or less of similar or related work experience.
• HIPAA trained and/or the ability to protect confidential information.

Responsabilidades

• Initiates and completes prior authorizations and appeals for specialty pharmacy for all patients of an assigned product program.
• Communicates with providers, health plans, PBMs, Pharma partners, and patients to obtain status of pending prior authorizations and appeals.
• Submits prior authorization and/or appeal requests via electronic, phone or fax on behalf of physicians/providers as allowed.
• Maintains all PA documents and records accurately and timely.
• Adheres to company policies and participates in program team activities.

Conhecimentos

Excel

Word

Outlook

Insurance verification

PA/PAP experience

Communication

Medicare knowledge

HIPAA awareness

Deadline-driven

Team collaboration

Formação académica

High School Diploma

Descrição da oferta de emprego

Amber Specialty Pharmacy is seeking a Dedicated Authorization Management Specialist to handle prior authorizations and appeals for a designated product program. You will liaise with prescribers, health plans, PBMs, and patients to secure timely approvals and maintain accurate documentation.

The role is office-based in a healthcare setting, requiring HIPAA awareness, strong Excel/Outlook skills, and ability to meet strict deadlines while delivering excellent customer service.