Remote Pharmacist: Prior Authorization Expert

Fairweather, LLC; Orlando (FL); Remote; USD 69,000 - 77,000; Full time

Benefits offered by this job

Benefits after 90 days

401(k) with company match

Job summary

A-Line Staffing Solutions in Orlando, FL is seeking a Pharmacist for remote Prior Authorization roles. Several openings with September start dates, paying $53.00 per hour, depending on the role.

The RPh Advisor reviews prior authorization requests, verifies insurance coverage and eligibility, interprets clinical guidelines, and communicates decisions promptly to providers, health plans and patients. Medicare Part D knowledge is essential; PBM experience is preferred.

Qualifications

• Must be a licensed Pharmacist in the state you reside in.
• Seeking Pharmacist with Prior Authorization experience – PBM; not retail.
• Must have home office/work-from-home capability with ethernet connection.

Responsibilities

• Evaluate and review all prior authorization requests and render coverage determinations.
• Verify insurance coverage and eligibility and interpret clinical guideline criteria.
• Consult physicians and other healthcare providers and communicate decisions promptly to providers, health plans and patients.
• Support Medicare Part D members and providers and ensure timely documentation.

Skills

Prior Authorization

PBM

Remote work

Pharmacist license

Medicare Part D

Provider outreach

Job description

A-Line Staffing Solutions in Orlando, FL is seeking a Pharmacist for remote Prior Authorization roles. Several openings with September start dates, paying $53.00 per hour, depending on the role.

The RPh Advisor reviews prior authorization requests, verifies insurance coverage and eligibility, interprets clinical guidelines, and communicates decisions promptly to providers, health plans and patients. Medicare Part D knowledge is essential; PBM experience is preferred.