Specialty Pharmacy Authorization Coordinator

Job Overview
We have a unique opportunity for a Specialty Pharmacy Authorization Coordinator to join a winning team providing Home Infusion Therapy and Specialty Medications for patients in their homes.

Duties

• Coordinate work flow of authorizations and reauthorizations for the Specialty, Pharmacy and Enteral teams, working closely with the Specialty Team Lead, Senior Lead Technician and Enteral Coordinator.
• Assisting the Specialty Team Lead with insurance authorization initiation and maintaining the reauthorizations throughout the patient's therapy.
• Assisting with making sure there is an authorization on file before each dispense.
• Processes all Medicare Part D and Medi-cal RX electronic pharmacy claims and assists the billing supervisor with accepting claims.
• Submits any Medicare Part D or Medi-cal RX TARs as needed.
• Assists the Specialty Team Lead, Senior Lead Technician and Enteral Coordinator with the daily review of upcoming authorizations which will be expiring.
• Requests updated clinical as needed to obtain reauthorizations.
• Submits reauthorizations prior to current authorization on file expiring for patients with ongoing orders.
• Updates status of reauthorization using the authorization tracking list/progress notes as well as entering and tracking detailed progress notes with status updates.
• Follow ups with insurances as needed on all reauthorizations submitted to obtain a copy of approval, attach approval to patient's file and enter in the authorization number and dates to the authorization tracking list and progress notes with a follow up date.
• Ensures all continuation orders which require an authorization are submitted within 24 hours of receiving the order.

Qualifications

• High School Graduate
• Office and computer skills are necessary
• Medical Terminology Knowledge
• Medical Coding Experience
• Effective time management and organization skills

Job Type: Full-time

Pay: $18.00 - $23.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Ability to Commute:

• Visalia, CA 93291 (Required)

Ability to Relocate:

• Visalia, CA 93291: Relocate before starting work (Required)

Work Location: In person

Salary : $18 - $23