Authorization Representative

Authorization Representative (Administrative)

Our Pharmacy in Ridgefield Park, NJ is seeking a Full Time Authorization Representative to join our Billing Department. Under general supervision of the Billing Manager, and in accordance with local, state, federal and company laws and regulations provide a variety of Billing functions. Specialty Rx is a Long-Term Care pharmacy providing pharmaceutical services to long term care facilities and assisted living communities.

Specialty Rx takes pride in delivering personalized care and quality pharmacy services.

• Perform duties assigned by the Billing Supervisor.
• Evaluate medication orders and prescriptions from long-term care facilities.
• Identify high-cost medications requiring authorization for dispensation.
• Liaise with facility staff to gather patient information and clinical documentation.
• Initiate and manage the authorization process for high-cost drugs, ensuring timely approval.
• Collaborate with healthcare providers and payers to address any authorization-related queries or concerns.
• Maintain accurate records of authorization requests, approvals, and denials.
• Provide guidance to facility staff on medication authorization procedures and requirements.
• Stay updated on regulatory guidelines and payer policies related to high-cost drug authorizations.
• Communicate effectively with internal teams and external clients regarding authorization status and issues.
• Participate in training sessions and quality improvement initiatives to enhance authorization processes.
• Assist in resolving any discrepancies or issues related to medication authorizations.
• Stay up to date across different platforms and pharmacies to ensure authorizations are being addressed timely.

• H.S. diploma or equivalent
• Courteous and polite phone skills
• Computer literate
• Ability to work nights and weekends
• Previous experience in Retail pharmacy a must
• Experience in Long Term Care Pharmacy (Preferred)
• Must be detail oriented
• Must be able to multitask

Hours: Full Time;
Fri, Sat, Sun and Mondays; 2pm-12am or Fri, Sat, Sun, Mon and Wednesday 2pm-10pm

EEO Statement, Specialty Rx, Inc. is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation and gender identity or any other status protected by federal, state or local law.
EO/Minorities/Females/Disabled/Veterans