Prior Authorization Coordinator Jobs in Renton, WA

Overview

Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, Fred Hutch is the only National Cancer Institute-designated cancer center in Washington.

With a track record of global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines, Fred Hutch has earned a reputation as one of the world's leading cancer, infectious disease and biomedical research centers. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services, and network affiliations with hospitals in five states. Together, our fully integrated research and clinical care teams seek to discover new cures to the world's deadliest diseases and make life beyond cancer a reality.

At Fred Hutch we value collaboration, compassion, determination, excellence, innovation, integrity and respect. Our mission is directly tied to the humanity, dignity and inherent value of each employee, patient, community member and supporter. Our commitment to learning across our differences and similarities make us stronger. We seek employees who bring different and innovative ways of seeing the world and solving problems.

The Pharmacy Prior Authorization Coordinator (Pharmacy Technician III) ensures that all authorizations/certifications for drug therapy are completed in accordance with payer criteria and policy, in a timely manner, and prior to therapy initiation. This position will work with stakeholders inside and outside of the pharmacy department to complete crucial and complex tasks relating to patient care, financial and billing practices, or regulatory compliance.

This is a full-time position with a schedule of Monday through Friday, 9:00am to 5:30pm PT. There is also potential for this role to be hybrid or fully remote, depending on business needs and team approval.

Responsibilities

• Performs complex and unique duties within the pharmacy department
• Interpret, evaluate, and summarize information and datasets of varying sizes
• Communicate effectively and professionally with stakeholder inside and outside of pharmacy department
• Develop and maintain internal (within Fred Hutch) and external relationships (such as vendors, payors, distributors)
• Work independently and within teams to complete tasks
• Documentation information or results in clear and concise ways
• Generate and present reports of tasks to Pharmacy Operations Manager or Director of Pharmacy
• Other duties as assigned
• Determine benefit limits and secure insurance approvals for specialty infusion, oral chemotherapy and high-cost medications
• Work closely with care team to communicate any coverage issues
• Evaluate patterns in denied claims taking corrective action and educating staff as needed
• Liaison with Patient Financial Services
• Serve as a resource to patients and staff regarding insurance and drug coverage questions
• Provide patient assistance program information and education to providers, patients and medical center staff
• Completing and submitting prior authorization forms and patient assistance applications
• Reprocessing denied or rejected third party claims
• Train and educate staff on pharmacy billing functions
• Participate in billing related meetings
• Retail pharmacy reconciliation and reporting
• Other pharmacy related duties in accordance with regulations under Washington State Pharmacy Quality Assurance Commission

Qualifications

Required:

• High school diploma or equivalent
• Current Washington state pharmacy technician certification.
• 2 years pharmacy technician experience
• Proficient in Microsoft suite
• Ability to communicate verbally in person, on the phone, and in writing in a clear, concise and professional manner
• Ability to use a mouse, navigate computer programs, enter data into computer systems accurately and efficiently
• Attention to detail and accuracy documentation of information
• Ability to multitask and work efficiently in a dynamic work environment
• Ability to work effectively as a member of a team
• Experience with electronic medical records
• Familiar with the generic names of drugs along with their basic indication
• Able to perform basic pharmaceutical calculations
• Review and correct discrepancies identified in daily, weekly and monthly billing reports
• Ability to work in a fast paced and complex environment

Preferred:

• Previous experience in pharmacy billing/prior authorization
• Knowledge of CPT, ICD-10 and other medical terminology
• Knowledge of the health care environment and electronic medical records
• Attention to detail and accuracy documentation of information
• Ability to multitask and work efficiently in a dynamic work environment
• Ability to work effectively as a member of a team
• Experience with electronic medical records[GK1] 

Pre Employment Drug Screening: As a condition of employment Fred Hutch conducts pre-employment drug testing for this pharmacy role. All offers of employment in the pharmacy department are conditional on the applicant successfully completing and passing a drug test in accordance with the Fred Hutch policy.

The hourly pay range for this position is from $35.09 to $52.63 and pay offered will be based on experience and qualifications.  

This is a full-time position with a schedule of Monday through Friday, 9:00am to 5:30pm PT. There is also potential for this role to be hybrid or fully remote, depending on business needs and team approval.Although Fred Hutch is not sponsoring most H-1B visas at this time, candidates who already hold an H-1B sponsored by another organization and are currently in the U.S. may be eligible for this position.Fred Hutchinson Cancer Center offers employees a comprehensive benefits package designed to enhance health, well-being, and financial security. Benefits include medical/vision, dental, flexible spending accounts, life, disability, retirement, family life support, employee assistance program, onsite health clinic, tuition reimbursement, paid vacation (12-22 days per year), paid sick leave (12-25 days per year), paid holidays (13 days per year), paid parental leave (up to 4 weeks). 

Additional InformationWe are proud to be an Equal Employment Opportunity (EEO) and Vietnam Era Veterans Readjustment Assistance Act (VEVRAA) Employer. We do not discriminate on the basis of race, color, religion, creed, ancestry, national origin, sex, age, disability (physical or mental), marital or veteran status, genetic information, sexual orientation, gender identity, political ideology, or membership in any other legally protected class. We desire priority referrals of protected veterans. If due to a disability you need assistance/and or a reasonable accommodation during the application or recruiting process, please send a request to Human Resources at hrops@fredhutch.org or by calling 206-667-4700.Employment Type: FULL_TIME