Prior Authorization Specialist – Pharmacy Benefits Expert

BrightSpring Health Services; Denver (CO); On-site; USD 25,000 - 41,000; Full time

Benefits offered by this job

Health, Dental, Vision & Life

401k

Tuition Reimbursement

Paid Time Off

DailyPay

Pet Insurance

Company-Paid Disability

Job summary

Amerita in Denver, CO is hiring a Prior Authorization Specialist with Pharmacy background to manage initiation, clinical review, and submission of PA requests for medications and supplies. You will work with providers, insurers, and patients to gather information and ensure timely submissions.

Daily duties include accurate electronic submissions, adherence to payer guidelines, and knowledge of sig codes and brand/generic names. Strong math and analytical skills are required.

Qualifications

• 1+ years pharmacy experience.
• Knowledge of pharmacy terminology including sig codes and Roman numerals; familiarity with brand/generic names.
• Basic math and analytical skills.

Responsibilities

• Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply, ensuring compliance with payer requirements and clinical guidelines.
• Collaborate with healthcare providers, insurance companies, and patients to gather necessary clinical information and documentation to support prior authorization submissions.
• Submit prior authorization requests accurately and in a timely manner, utilizing electronic submission platforms and following established protocols.
• Knowledgeable to perform all PA functions.

Skills

Pharmacy experience

Pharmacy terminology

Attention to detail

Education

High School Diploma or GED

Licensed/registered Pharmacy Technician

Job description

Amerita in Denver, CO is hiring a Prior Authorization Specialist with Pharmacy background to manage initiation, clinical review, and submission of PA requests for medications and supplies. You will work with providers, insurers, and patients to gather information and ensure timely submissions.

Daily duties include accurate electronic submissions, adherence to payer guidelines, and knowledge of sig codes and brand/generic names. Strong math and analytical skills are required.