Prior Authorization Pharmacy Specialist

Overview

PHARMACY PRIOR AUTHORIZATION REPRESENTATIVE

Interview at our Hiring Event with our managers on Tuesday, February 6TH.

H
ours: We are hiring for multiple 8 Hour shifts beginning at 8, 9, 10 or 11AM.

Exceptional Benefits: 10 Paid holidays, 19 PTO days off per year, Medical, Dental, Vision, 401K.

Prior Authorization/Fulfillment Specialist with 1 Year Pharmacy Experience

We offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

Build the Possibilities. Make an Extraordinary Impact. Contact us today for immediate consideration. We have multiple openings.

Location: This position will work ONSITE 5 days/week at our office in Denver, CO

The Authorization Representative II is responsible for the administration of prior authorizations requests for patients whose health plan requires drug prior authorizations for different therapy types.

How you will make an impact:

Present and meet company set standards.
Assists with the completion of medical necessity documentation to expedite approvals and ensures that appropriate follow up is performed.
Collaborates with other departments to assist in obtaining prior authorizations/appeals.
Document insurance company interactions and all prior authorization information in system.
Reviews insurance denials and submit appeals as permitted by payor.
Contacts physician offices as needed to obtain demographic information or medical data.
Minimum Requirements:

Requires a HS diploma or GED and a minimum of 1 years’ experience processing pharmacy prior authorizations, and a minimum of 1 year of experience applying knowledge of Medicare, Medicaid and Managed Care reimbursement guidelines; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences

Specialty pharmacy experience highly preferred.
Medical terminology training preferred.

One year pharmacy experience required.