BrightSpring Health Services
Prior Authorization Specialist / Remote
BrightSpring Health Services, Oklahoma City, Oklahoma, United States, 73116
Employer Industry: Home Infusion Therapy
Why consider this job opportunity:
Salary up to $23.00 per hour
Comprehensive benefits including health, dental, vision, and life insurance
Company-paid short and long-term disability coverage
Flexible schedules with paid time off and tuition reimbursement
Employee discount program and daily pay options
401k plan and pet insurance
What to Expect (Job Responsibilities):
Initiate, process, and oversee the clinical review of prior authorization requests for medication and supplies, 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
Maintain knowledge to perform all prior authorization functions
Ensure adherence to clinical guidelines and payer requirements during the authorization process
What is Required (Qualifications):
High School Diploma or GED, or licensed/registered pharmacy technician, or previous experience in pharmacy
Minimum of 1 year of pharmacy experience
Knowledge of pharmacy or healthcare-related terms and practices
Familiarity with pharmacy terminology including sig codes, Roman numerals, and brand/generic names of medications
Basic math and analytical skills along with intermediate typing/keyboard skills
How to Stand Out (Preferred Qualifications):
Previous experience in prior authorization processes
Familiarity with electronic submission platforms for prior authorizations
Strong communication skills for collaboration with healthcare providers and patients
Ability to work effectively in a fast-paced environment
Understanding of insurance payer requirements and clinical guidelines
We prioritize candidate privacy and champion equal-opportunity employment.
#J-18808-Ljbffr
Why consider this job opportunity:
Salary up to $23.00 per hour
Comprehensive benefits including health, dental, vision, and life insurance
Company-paid short and long-term disability coverage
Flexible schedules with paid time off and tuition reimbursement
Employee discount program and daily pay options
401k plan and pet insurance
What to Expect (Job Responsibilities):
Initiate, process, and oversee the clinical review of prior authorization requests for medication and supplies, 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
Maintain knowledge to perform all prior authorization functions
Ensure adherence to clinical guidelines and payer requirements during the authorization process
What is Required (Qualifications):
High School Diploma or GED, or licensed/registered pharmacy technician, or previous experience in pharmacy
Minimum of 1 year of pharmacy experience
Knowledge of pharmacy or healthcare-related terms and practices
Familiarity with pharmacy terminology including sig codes, Roman numerals, and brand/generic names of medications
Basic math and analytical skills along with intermediate typing/keyboard skills
How to Stand Out (Preferred Qualifications):
Previous experience in prior authorization processes
Familiarity with electronic submission platforms for prior authorizations
Strong communication skills for collaboration with healthcare providers and patients
Ability to work effectively in a fast-paced environment
Understanding of insurance payer requirements and clinical guidelines
We prioritize candidate privacy and champion equal-opportunity employment.
#J-18808-Ljbffr