Pharmacy Prior Authorization Specialist

What You’ll Do: The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests. How You’ll Do ThisManage prior authorization requests and appeals with insurance carriers. Collaborate with physicians, pharmacists, and other departments. Ensure HIPAA compliance while handling sensitive patient information. Maintain accurate documentation of authorization details. Proactively monitor and renew expiring authorizations. What You BringHigh School Diploma or GED1+ years of pharmacy or prior authorization experience Registration with Board of Pharmacy (as required by state law) Strong communication, organizational, and customer service skills Self-motivated, organized, detail-oriented, and adaptable to changing priorities Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMedsPreferredAssociate degree or Certified Pharmacy Technician (PTCB)3+ years of experience in pharmacy or prior authorizations Specialty pharmacy experience