Prior Authorization Specialist / Remote

BrightSpring Health Services; United States; Remote; USD 30,307 - 35,817; Full time

Job summary

A healthcare institution in the United States is seeking a Pharmacy Authorization Specialist responsible for overseeing the initiation and management of prior authorizations for medication and supplies. The role requires at least a High School Diploma or GED, along with 1+ years of pharmacy experience. Responsibilities include collaborating with providers and insurance companies to gather necessary documentation. This position offers a competitive hourly wage of $22.00 to $26.00, operating Monday to Friday from 8:30 am to 5:30 pm.

Qualifications

• High School Diploma or GED or licensed pharmacy technician or equivalent experience.
• 1+ years of pharmacy experience is required.
• Basic knowledge of pharmacy benefits and prior authorization process.

Responsibilities

• Initiate and oversee prior authorization requests for medication.
• Collaborate with providers and patients to gather supporting information.
• Submit prior authorization requests through electronic platforms.

Skills

Knowledge of pharmacy terminology

Basic math skills

Intermediate typing skills

Analytical skills

Education

High School Diploma or GED

Licensed/registered pharmacy technician

Job description

Overview

This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process.

Shift: Monday-Friday 8:30am-5:30pm (EST)

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.

Qualifications

• High School Diploma or GED or licensed/registered pharmacy technician or previous experience in Pharmacy
• 1+ years pharmacy experience
• Pharmacy or healthcare-related knowledge
• Knowledge of pharmacy terminology including sig codes, and Roman numbers, brand/generic names of medication
• Basic math and analytical skills
• Intermediate typing/keyboard skills

Additional Job Information

Percentage of Travel: 0-25%

Salary Range

USD $22.00 - $26.00 / Hour