Prior Authorization Coordinator
PharMerica
1 hour ago
Full-time
On-site
Jeffersontown, Kentucky, United States
Registered Nurse
Our Company
PharMerica
Overview
Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode , which means advancement opportunities for individuals who are looking for career progression!
Schedule : Mon-Fri(8:30am to 5pm)
This is not a remote opportunity . Applicants must reside in, or commutable distance, to Louisville, KY
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!
*Position will be posted for a minimum of 7 business days
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 PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.
PharMerica
Overview
Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode , which means advancement opportunities for individuals who are looking for career progression!
Schedule : Mon-Fri(8:30am to 5pm)
This is not a remote opportunity . Applicants must reside in, or commutable distance, to Louisville, KY
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!
*Position will be posted for a minimum of 7 business days
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 PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.