Prior Authorization Specialist in Pharmacy

Job Title: Pharmacy Prior Authorization Specialist

Job Overview

Join our dedicated team as a Pharmacy Prior Authorization Specialist in Pittsburgh, PA, where your commitment to improving patient access to essential medications will truly make a difference. In this pivotal role, you will serve as an essential liaison among patients, healthcare providers, and insurance companies, ensuring that the prior authorization process is streamlined and efficient.

Key Responsibilities

• Initiate new prior authorization requests to healthcare providers.
• Determine the appropriate prior authorization forms required for each patient’s insurance plan.
• Collaborate with prescribers and medical offices to ensure accurate form completion.
• Proactively follow up with medical offices regarding the status of prior authorization requests.
• Communicate the status of prior authorizations effectively to patients and providers.
• Manage appeals in coordination with medical offices.
• Address internal inquiries related to prior authorizations.
  
  

Required Skills

• Strong verbal and written communication abilities.
• Excellent technical skills paired with analytical capacity.
• Attention to detail, sound judgment, and operational focus.
• Proven customer service skills and the ability to work well in a team-oriented environment.
• Flexibility to adapt to rotating shifts from 8 AM to 8 PM, including some Saturdays from 9 AM to 5 PM.
  
  

Qualifications

• High school diploma or GED is required; a Bachelor’s degree is strongly preferred.
• Experience in customer service or within an inbound call center is necessary.
• A minimum of one year of experience with prior authorizations or insurance verification within a pharmacy is preferred.
• Familiarity with pharmacy benefits and claims is an added advantage.
  
  

Career Growth Opportunities

This position presents an exceptional opportunity to join the fastest-growing healthcare technology organization in the country. You will be part of a dynamic environment that encourages professional growth and development, enabling you to enhance your skills and advance your career.

Company Culture And Values

We foster a collaborative environment where innovation in healthcare thrives. Our team is passionate about making medications more accessible and affordable, reflecting our commitment to impactful work. We value diversity and are an equal opportunity employer, ensuring a work environment free from discrimination.

Why Join Us?

As a Pharmacy Prior Authorization Specialist, you will be part of a rapidly expanding company that is revolutionizing the healthcare landscape. This role allows you to contribute directly to improving the lives of millions of patients, while also engaging in a culture of continuous learning and collaboration.

Employment Type: Full-Time