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Prior Authorization Specialist
- BrightSpring Health Services (Louisville, KY)
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Our Company
Pharmacy Alternatives
Overview
Hybrid
Join our Pharmacy Alternative team! PharMerica is aclosed-door pharmacywhere you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization is inhigh growth mode, which meansadvancement opportunitiesfor individuals who are looking for career progression!
Pharmacy Technician preferred.
Schedule: Monday-Friday from 8:30am - 5pm Central Time.
This role is based out of Louisville, KY and after training, will become a hybrid schedule with time spent in the office as well as your home office.
Hybrid Schedule:Home Office on Monday, Tuesday, Thursday, & Friday. On Site on Wednesdays
Applicants must live in or a commutable distnce to Louisville.
We offer:
DailyPay
Flexible schedules
Competitive pay
Shift differential
Health, dental, vision and life insurance benefits
Company paid STD and LTD
Tuition Assistance
Employee Discount Program
401k
Paid-time off
Tuition reimbursement
Non-retail/Closed-door environment
Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!
Responsibilities
+ The Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with prescribers and or facility contact to have therapy changed to a preferred alternative due to insurance not covering the treatment in question
Essential Job Responsibilities:
+ Ensure accurate and timely completion of client prior authorization and/or change of therapy paperwork by collaborating with prescribers and facility contacts
+ Follows up on all claims requiring prior authorization within four to five business days
+ Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of Pharmacy on weekly basis
+ Compares system report of unbilled claims requiring prior approval to QuickBase tracking system to ensure any claim requiring prior authorization is being followed up on
+ Assists Billing Department with resolving unbilled claims at each month end close
+ Advocates for clients as needed
+ Support for Pharmacy Operations
+ Adjudicates and resolution of claim rejections as needed
+ Utilizes Frameworks, QuickBase, Docutrack, and CoverMyMeds in order to complete workflow on daily basis
+ Other responsibilities as assigned
Qualifications
+ High School Diploma/General Education Diploma required
+ Kentucky Pharmacy Technician License preferred
+ Excellent customer service and communication skills, both written and verbal
+ Ability to prioritize and meet pre-determined deadlines
+ Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
+ Experience in healthcare billing environment (pharmacy preferred)
+ Familiarization with on-line claims processing and Medicaid and Medicare billing practices
+ Proficient with Microsoft Word & Excel required
About our Line of Business
Pharmacy Alternatives®, an affiliate of PharMerica, is a specialized pharmacy provider focused on serving individuals with cognitive or intellectual and developmental disabilities (I/DD). Pharmacy Alternatives offers long-term pharmacy solutions specializing in serving special-needs populations who live in intermediate care facilities, waiver homes, group homes, assisted living, supported-living or foster care. PharMerica is one of the nation's largest pharmacy companies. PharMerica offers unmatched company culture, employee development, and advancement opportunities. For more information, please visitwww.pharmacyalternatives.com. Follow us onFacebook (https://www.facebook.com/pharmacyalternatives) andLinkedIn (https://www.linkedin.com/company/pharmacy-alternatives-llc) .
Salary Range
USD $15.25 / Hour
ALERT: We are aware of a scam whereby imposters are posing as employees from our company. Beware of anyone requesting financial or personal information. We take pride in creating a best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card, driver’s license, bank information, or payment for work equipment, etc.) from you via text or email. If you are suspicious of a job posting or job-related email mentioning our company, please contact us at [email protected] .
Click here (https://www.brightspringhealth.com/careers/frequently-asked-questions/) for additional FAQ information.
Job LocationsUS-KY-LOUISVILLE
ID 2025-168188
Line of Business Pharmacy Alternatives
Position Type Full-Time
Pay Min USD $15.25/Hr.
Pay Max USD $15.25/Hr.
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