AmeriPharma
Overview
Join to apply for the
Prior Authorization Specialist
role at
AmeriPharma . We are seeking a highly organized and detail-oriented individual to join our dynamic pharmacy team. This role supports patient care by minimizing delays in treatment and works closely with healthcare providers, insurance carriers, and internal teams. Job Summary
We are seeking a highly organized and detail-oriented Prior Authorization Coordinator to join our dynamic pharmacy team. This individual will play a key role in ensuring timely and accurate submission, follow-up, and approval of prior authorizations and appeals for medical and prescription services. Schedule Details
Location: On-Site (Training in Orange, CA; position based in Laguna Hills, CA post-training) Hours: Monday to Friday, 8:30 AM – 5:00 PM Duties and Responsibilities
Ensure timely, accurate submission, follow-up, and approval of prior authorizations for medications and medical services Review requests and documentation for completeness and accuracy; ensure all supporting materials are submitted Communicate with healthcare providers, insurance companies, patients, and internal teams to clarify and resolve authorization issues Assist in gathering and submitting documentation to support medical necessity appeals Proactively manage and track authorization requests, expirations, and renewals Document all interactions with stakeholders in the system clearly and consistently Log all prior authorization details (e.g., approval dates, billing units, procedure codes, authorization numbers) into the patient profile Collaborate with clinical, billing, and intake departments to coordinate and resolve outstanding authorization or billing issues Stay current on payer-specific guidelines and regulatory requirements regarding authorizations and appeals Maintain compliance with company policies, procedures, and applicable laws and standards Complete required daily, weekly, and monthly reports as assigned by leadership Perform other duties as assigned Experience And Skills Requirements
Minimum of 2 years of experience in prior authorization, preferably in infusion services, specialty pharmacy, or a medical office Strong understanding of Medicare, Medicaid, and Managed Care reimbursement and prior authorization requirements Familiarity with medical terminology, insurance processes, and prescription medications Demonstrated ability to work in a fast-paced, high-volume environment and manage multiple priorities Strong analytical, critical thinking, and problem-solving skills Excellent verbal and written communication skills Intermediate-level proficiency in Microsoft Excel, Word, and experience with electronic health systems or pharmacy software High level of attention to detail and accuracy in documentation Ability to work independently and as part of a collaborative team Preferred Qualifications
Experience with appeals and insurance claim processing Prior experience working in a paperless workflow environment Experience with EMR, CPR+, or prior authorization platforms Benefits
Full benefits package including medical, dental, vision, life that fits your lifestyle and goals Great pay and general compensation structures Employee assistance program to assist with mental health, legal questions, financial counseling etc. Comprehensive PTO and sick leave options 401k program Plenty of opportunities for growth and advancement Company sponsored outings and team-building events Casual Fridays About AmeriPharma
AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves. Job Requirements and Compliance
AmeriPharma’s Mission Statement: Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients, prescribers, colleagues, and others that We Care! EEO Statement
The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.
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Join to apply for the
Prior Authorization Specialist
role at
AmeriPharma . We are seeking a highly organized and detail-oriented individual to join our dynamic pharmacy team. This role supports patient care by minimizing delays in treatment and works closely with healthcare providers, insurance carriers, and internal teams. Job Summary
We are seeking a highly organized and detail-oriented Prior Authorization Coordinator to join our dynamic pharmacy team. This individual will play a key role in ensuring timely and accurate submission, follow-up, and approval of prior authorizations and appeals for medical and prescription services. Schedule Details
Location: On-Site (Training in Orange, CA; position based in Laguna Hills, CA post-training) Hours: Monday to Friday, 8:30 AM – 5:00 PM Duties and Responsibilities
Ensure timely, accurate submission, follow-up, and approval of prior authorizations for medications and medical services Review requests and documentation for completeness and accuracy; ensure all supporting materials are submitted Communicate with healthcare providers, insurance companies, patients, and internal teams to clarify and resolve authorization issues Assist in gathering and submitting documentation to support medical necessity appeals Proactively manage and track authorization requests, expirations, and renewals Document all interactions with stakeholders in the system clearly and consistently Log all prior authorization details (e.g., approval dates, billing units, procedure codes, authorization numbers) into the patient profile Collaborate with clinical, billing, and intake departments to coordinate and resolve outstanding authorization or billing issues Stay current on payer-specific guidelines and regulatory requirements regarding authorizations and appeals Maintain compliance with company policies, procedures, and applicable laws and standards Complete required daily, weekly, and monthly reports as assigned by leadership Perform other duties as assigned Experience And Skills Requirements
Minimum of 2 years of experience in prior authorization, preferably in infusion services, specialty pharmacy, or a medical office Strong understanding of Medicare, Medicaid, and Managed Care reimbursement and prior authorization requirements Familiarity with medical terminology, insurance processes, and prescription medications Demonstrated ability to work in a fast-paced, high-volume environment and manage multiple priorities Strong analytical, critical thinking, and problem-solving skills Excellent verbal and written communication skills Intermediate-level proficiency in Microsoft Excel, Word, and experience with electronic health systems or pharmacy software High level of attention to detail and accuracy in documentation Ability to work independently and as part of a collaborative team Preferred Qualifications
Experience with appeals and insurance claim processing Prior experience working in a paperless workflow environment Experience with EMR, CPR+, or prior authorization platforms Benefits
Full benefits package including medical, dental, vision, life that fits your lifestyle and goals Great pay and general compensation structures Employee assistance program to assist with mental health, legal questions, financial counseling etc. Comprehensive PTO and sick leave options 401k program Plenty of opportunities for growth and advancement Company sponsored outings and team-building events Casual Fridays About AmeriPharma
AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves. Job Requirements and Compliance
AmeriPharma’s Mission Statement: Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients, prescribers, colleagues, and others that We Care! EEO Statement
The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.
#J-18808-Ljbffr