Prior Authorization Specialist
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Job Description & Specifications
Official role breakdown, eligibility standards, and core responsibilities
Prior Authorization Specialist at BrightSpring Health Services
Location Guidelines: United States · Workplace: 🌐 Remote
Overview
This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow-up of prior authorizations. This role requires working knowledge of pharmacy benefits and the prior authorization process.
• Competitive Pay
- Health, Dental, Vision & Life Insurance
- Company-Paid Short & Long-Term Disability • Flexible Schedules & Paid Time Off• Tuition Reimbursement • Employee Discount Program & DailyPay• 401k
Responsibilities
- Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply, ensuring compliance with payer requirements and clinical guidelines.
- Collaborate with healthcare providers, insurance companies, and patients to gather necessary clinical information and documentation to support prior authorization submissions.
- Submit prior authorization requests accurately and in a timely manner, utilizing electronic submission platforms and following established protocols.
- Knowledgeable to perform all PA functions.
Qualifications
- High School Diploma or GED or licensed/registered pharmacy technician or previous experience in Pharmacy
- 1+ years pharmacy experience
- Pharmacy or healthcare-related knowledge
- Knowledge of pharmacy terminology including sig codes, and Roman numbers, brand/generic names of medication
- Basic math and analytical skills
- Intermediate typing/keyboard skills
About our Line of Business
Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit www.ameritaiv.com. Follow us on Facebook, LinkedIn, and X.
Additional Job Information
Percentage of Travel:0-25%
Salary Range
USD $22.00 - $30.00 / Hour
Originally posted on Himalayas
How to Apply: Click "Apply for this Job" to be redirected directly to BrightSpring Health Services's official application form.
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