Polaris Pharmacy Services
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Prior Authorization Specialist
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Polaris Pharmacy Services 3 weeks ago – Be among the first 25 applicants About Polaris Pharmacy Services
Polaris Pharmacy Services is more than a pharmacy – we are a dedicated partner in care, transforming how patients experience long‑term, post‑acute, correctional, PACE, and specialty pharmacy services. Founded in 2015, Polaris is locally and independently owned with a growing national footprint. Our mission‑driven environment values innovation and purpose, offering competitive pay, robust benefits, and genuine opportunities for career advancement. Job Summary
The Prior Authorization Specialist manages and resolves a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing, protecting Polaris and its customers from financial risk. Specialists are responsive, courteous, and dedicated to meeting expectations, using customer information to improve services, and building trust with co‑workers and customers. Responsibilities
Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing. Research, analyze, and resolve rejected claims with national Medicare D plans, third‑party insurers, and all state Medicaid plans to meet critical deadlines. Perform appropriate edits and/or reversals to ensure maximum payer reimbursement. Contact providers or facility contacts as necessary to obtain additional information. Monitor and resolve revenue at risk associated with payer setup, billing, re‑billing, and reversal processes. Collaborate as a team to identify, document, communicate, and resolve payer/billing trends and issues. Complete, communicate, and submit prior authorization forms in a timely manner. Support training needs. Prepare and maintain reports and records for processing. Perform other tasks as assigned. Ensure compliance with all applicable government regulations, including HIPAA. Follow departmental policies regarding safety, attendance, and dress code. Work overtime, holidays, and weekends as required or expected. Conduct job responsibilities in accordance with the company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and professional standards. Qualifications
Required Skills
Read, write, speak, and understand English. Retain and apply large amounts of information to related situations. Work effectively in a fast‑paced environment. Basic computer knowledge and math/analytical skills. Experience with alpha‑numeric data entry. Proficiency in Microsoft Word, Excel, and Outlook. Excellent customer service skills. Results‑oriented with strong organization and attention to detail. Reliable and a problem solver. Ability to work various shifts and days. Adaptability to an ever-changing environment. Education & Experience
High School diploma or equivalent required. Minimum of one year as a pharmacy technician in a retail environment preferred (long‑term care pharmacy preferred). Framework LTC & general computer knowledge & 10‑key number entry preferred. Physical Demands
May sit or stand seven to ten hours per day. Occasionally required to sit, climb, balance, stoop, kneel, bend, or walk. May need to work extended hours. May lift and/or move up to 30 pounds. Holiday & PTO Policy
Paid holidays: 6 days per year, plus 5 sick days. Up to 10 PTO days per year with rollover options and milestone bonuses. Option to cash out up to 10 PTO hours per quarter. Benefits for Full‑Time Employees
Medical, Dental, and Vision insurance. 401(k) available for both part‑time and full‑time employees. Company‑paid life insurance. Short‑term and long‑term disability insurance. Tuition reimbursement. Personal Time Off (PTO). Competitive pay with annual performance reviews and merit‑based raises. Career growth potential. Annual on‑site voluntary flu vaccines. Employee referral bonus program. Seniority Level
Entry level Employment Type
Other Job Function
Other Industries
Pharmaceutical Manufacturing Referrals increase your chances of interviewing at Polaris Pharmacy Services by 2x.
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Prior Authorization Specialist
role at
Polaris Pharmacy Services 3 weeks ago – Be among the first 25 applicants About Polaris Pharmacy Services
Polaris Pharmacy Services is more than a pharmacy – we are a dedicated partner in care, transforming how patients experience long‑term, post‑acute, correctional, PACE, and specialty pharmacy services. Founded in 2015, Polaris is locally and independently owned with a growing national footprint. Our mission‑driven environment values innovation and purpose, offering competitive pay, robust benefits, and genuine opportunities for career advancement. Job Summary
The Prior Authorization Specialist manages and resolves a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing, protecting Polaris and its customers from financial risk. Specialists are responsive, courteous, and dedicated to meeting expectations, using customer information to improve services, and building trust with co‑workers and customers. Responsibilities
Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing. Research, analyze, and resolve rejected claims with national Medicare D plans, third‑party insurers, and all state Medicaid plans to meet critical deadlines. Perform appropriate edits and/or reversals to ensure maximum payer reimbursement. Contact providers or facility contacts as necessary to obtain additional information. Monitor and resolve revenue at risk associated with payer setup, billing, re‑billing, and reversal processes. Collaborate as a team to identify, document, communicate, and resolve payer/billing trends and issues. Complete, communicate, and submit prior authorization forms in a timely manner. Support training needs. Prepare and maintain reports and records for processing. Perform other tasks as assigned. Ensure compliance with all applicable government regulations, including HIPAA. Follow departmental policies regarding safety, attendance, and dress code. Work overtime, holidays, and weekends as required or expected. Conduct job responsibilities in accordance with the company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and professional standards. Qualifications
Required Skills
Read, write, speak, and understand English. Retain and apply large amounts of information to related situations. Work effectively in a fast‑paced environment. Basic computer knowledge and math/analytical skills. Experience with alpha‑numeric data entry. Proficiency in Microsoft Word, Excel, and Outlook. Excellent customer service skills. Results‑oriented with strong organization and attention to detail. Reliable and a problem solver. Ability to work various shifts and days. Adaptability to an ever-changing environment. Education & Experience
High School diploma or equivalent required. Minimum of one year as a pharmacy technician in a retail environment preferred (long‑term care pharmacy preferred). Framework LTC & general computer knowledge & 10‑key number entry preferred. Physical Demands
May sit or stand seven to ten hours per day. Occasionally required to sit, climb, balance, stoop, kneel, bend, or walk. May need to work extended hours. May lift and/or move up to 30 pounds. Holiday & PTO Policy
Paid holidays: 6 days per year, plus 5 sick days. Up to 10 PTO days per year with rollover options and milestone bonuses. Option to cash out up to 10 PTO hours per quarter. Benefits for Full‑Time Employees
Medical, Dental, and Vision insurance. 401(k) available for both part‑time and full‑time employees. Company‑paid life insurance. Short‑term and long‑term disability insurance. Tuition reimbursement. Personal Time Off (PTO). Competitive pay with annual performance reviews and merit‑based raises. Career growth potential. Annual on‑site voluntary flu vaccines. Employee referral bonus program. Seniority Level
Entry level Employment Type
Other Job Function
Other Industries
Pharmaceutical Manufacturing Referrals increase your chances of interviewing at Polaris Pharmacy Services by 2x.
#J-18808-Ljbffr