Pharmacy Prior Authorization Specialist

Pharmacy Prior Authorization Specialist page is loaded## Pharmacy Prior Authorization Specialist locations:
Pharmacy Solutions Group - Ohiotime type:
Full time posted on:
Posted Todayjob requisition :
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- ** Job Address:
** 9299 Market Place Broadview Heights, OH 44147
** Job Description****:
** Prior Authorization Specialist
** Reports to****:
** Pharmacy Prior Authorization Manager
** Job Type****:
** Full-Time – Remote – Pharmacies:
West Virginia, Ohio, Indiana and Maryland
** Position Overview****:
** The Prior Authorization Specialist will maintain the Prior Authorization’s workflow for a set of facilities assigned by the supervisor, while providing customer service to clients. He/she wil enter required information and submit Prior Authorizations to the respective plan, follow the prior authorization to completion, identify and clarify any discrepancies with a prior authorization, and participate in the appeal process.
** Key Responsibilities Include but are not limited to****:
*** Work in cohesion with the Adjudication, Claim Intervention and Billing Departments
* Submit prior authorizations in accordance with Insurance regulations
* Ensure accurate and timely processing of prior authorizations
* Work directly with insurance companies for prior authorization resolution
* Communicate with facilities to gain additional information
* Any other duties assigned
* Follow federal and state regulations
* Adhere to company policies and procedures
* Follow HIPPA guidelines and regulations
** Qualifications and Requirements****:
*** Prior Authorization experience (not required)
* Previous Long-Term Care pharmacy experience a plus (not required)
* Knowledge of Framework LTC a plus (not required)
** Salary and Benefits****:
*** Competitive salary commensurate with experience
* Comprehensive benefits package, including health, dental, and vision insurance, 401(k) with company match, paid time off, and more
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