Specialty Pharmacy Prior Authorization Specialist

Hy-Vee Pharmacy Solutions; Omaha (NE); Hybrid; USD 26,000 - 28,000; Full time

Benefits offered by this job

Six paid holidays

Mon-Fri schedule 8am-5pm CST

Job summary

Amber Specialty Pharmacy is seeking an Authorization Management Specialist in the Operations department. The role involves preparing appeal summaries, prior authorizations, and communicating with providers, plans, and patients. The position is non-exempt and offers a Monday–Friday schedule with a daytime CST workday.

Wages range from $19.00 to $20.00 hourly with six paid holidays. Applicants must pass post-offer drug screening and background checks as required by policy and regulation.

Qualifications

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

Responsibilities

• Initiates and completes prior authorizations and appeals for specialty pharmacy.
• Communicates with providers, health plans, PBMs, and patients to obtain status.
• Submits PA/appeal requests via electronic, phone, or fax on behalf of physicians.
• Maintains accuracy and timeliness of all authorization documents.
• Assists in reviewing patient charts and payer requirements.

Skills

MS Excel

MS Word

MS Outlook

Insurance verification

Communication skills

Timely deadlines

Interpersonal skills

Medicare/Medicaid knowledge

PAP/PA experience

Reading handwriting in records

Education

High school diploma or equivalent

Pharmacy Technician Certification

Tools

Microsoft Outlook

Skype

EMR systems

Job description

Amber Specialty Pharmacy is seeking an Authorization Management Specialist in the Operations department. The role involves preparing appeal summaries, prior authorizations, and communicating with providers, plans, and patients. The position is non-exempt and offers a Monday–Friday schedule with a daytime CST workday.

Wages range from $19.00 to $20.00 hourly with six paid holidays. Applicants must pass post-offer drug screening and background checks as required by policy and regulation.