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Thank you for your interest in joining our team! Please review the job information below.
General Purpose of job:
The Pharmacy Prior Authorization Specialist will be responsible for conducting and completing necessary third party prior authorizations requests for high cost medications. Other areas of responsibility include pre-screening patients, managing reimbursement issues, identifying opportunities for improving reimbursement, and conducting retrospective utilization reviews.
Coordinate the identification, communication and resolution of problems relating medication reimbursement.
Completes prior authorization and provides other necessary documents to assure optimal reimbursement.
Works closely and communicates with the physicians and other team members involved in patient care.
Works closely with inpatient pharmacy team regarding medication procurement and scheduling of patient visits.
BS in Pharmacy or PharmD, with 1 to 3 years of clinical patient care and orders management experience.
Current licensure either by reciprocity or examination by the Texas State Board of Pharmacy.
Knowledge and skills related to computerized pharmacy systems, third party payors, and fiscal reimbursement knowledge related to ambulatory care practices.
Works independently with minimal supervision.
High level of customer service and communication skills.