Logo
BrightSpring Health Services

Prior Authorization Specialist

BrightSpring Health Services, Paterson, New Jersey, us, 07544

Save Job

Job Description

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 prior authorization process.

Schedule: Monday - Friday

8 : 30am - 5 : 00pm

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

Pet Insurance

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

#J-18808-Ljbffr