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Specialty Pharmacy Authorization Coordinator

Integrated Care Systems
Visalia, CA Full Time
POSTED ON 2/13/2025
AVAILABLE BEFORE 4/13/2025

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

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