Prior Authorization Specialist / Remote
About the role
About Our Client:The organization operates in the specialty infusion sector, providing complex pharmaceutical products and clinical services to patients outside of hospital settings. It aims to deliver high-quality service by combining administrative efficiency with local responsiveness and adaptability. The company focuses on meeting clinical needs through specialty pharmacy services and strives to maintain a balance of scale and personalized care.
About the Opportunity:The Prior Authorization Specialist plays a critical role in managing prior authorization requests for medications and supplies. This position ensures that submissions meet payer requirements and clinical guidelines, facilitating timely access to necessary treatments. The role impacts patient care by coordinating information flow among healthcare providers, insurers, and patients to support authorization approvals.
Responsibilities
- Initiate and process prior authorization requests for medications and supplies.
- Conduct clinical reviews to ensure compliance with payer and clinical guidelines.
- Collaborate with healthcare providers, insurance companies, and patients to gather clinical information.
- Submit prior authorization requests accurately and promptly using electronic platforms.
- Perform all functions related to prior authorization processes.
Requirements
- High School Diploma, GED, or licensed/registered pharmacy technician, or equivalent pharmacy experience.
- At least one year of pharmacy experience.
- Knowledge of pharmacy or healthcare terminology, including sig codes and medication names.
- Basic math and analytical skills.
- Intermediate typing and keyboard skills.
Pay
Salary range USD $21.00 - $26.00 per hour.
Benefits
- Health insurance
- Dental insurance
- Vision insurance
- Life insurance
- Company-paid short and long-term disability
- Flexible schedules and paid time off
- Tuition reimbursement
- Employee discount program
- DailyPay
- 401(k) plan
- Pet insurance