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Assistant Prior Authorization Specialist

PFSP Specialty Pharmacy Rahway, NJ

  • Expired: over a month ago. Applications are no longer accepted.
Job Description

 Specialty Pharmacy seeks bright, articulate, positive-minded and energetic Pharmacy Assistant Prior Authorization (PA) Specialist. We offer a competitive salary, benefit package including vacation, paid major holidays, health insurance, 401K with company match and room for growth!

Assistant Prior Authorization Specialist will be responsible for working with the Prior Authorization Specialist to obtain prior authorizations and appeals (as required) for a Specialty Pharmacy.

The Pharmacy Assistant Prior Authorization (PA) Specialist processes written and telephone requested services by providers for PFSP Specialty Pharmacy within established time frames, following PFSP criteria and guidelines. This position also completes data entry and provider notification to ensure timely service to patients.

This position is primarily responsible for working prescriptions specifically related to specialty pharmacy for various complex disease states, obtaining prior authorization from intermediaries and payers, including managed care companies, insurance companies.This position requires an enhanced level of knowledge for specific disease states to maximize revenue capture for high-cost medications and complex disease states.

Demonstrates working knowledge of all facets of role, relevant regulations, and organizational and departmental policies and procedures. Performs other duties and projects as assigned. Performs all duties in accordance with regulatory requirements and organizational policies and procedures.

Responsibilities will include:

  • Obtaining prior authorizations from intermediaries and payers
  • Experience in PA's for complex disease states is a plus - Onco, Nuero, HCV, HIV
  • Highly motivated team player with a positive attitude and the ability to self-direct and prioritize.
  • Physician & patient contact.
  • Medical billing experience is required for this position.
  • Maintaining accurate reporting via dispensing software/Excel workbooks and other duties as assigned.
  • Extensive knowledge of Microsoft Excel/Word a must.
  • CareTend by Wellsky experience a plus.
  • Must have a team-oriented mentality and be able to communicate effectively in this fast-paced Pharmacy environment.

Job Requirements:

  • This is a full-time salaried position.
  • Experience in completing prior authorization forms required
  • Minimum of one year in a similar operation required (health insurance, healthcare, specialty pharmacy and/or managed care arena)
  • Medicaid/Medicare experience required
  • Pharmacy call center experience or one year relevant experience preferred
  • Highly motivated team player with a positive attitude and the ability to self-direct and prioritize.
  • Must have a high school diploma or equivalent.
  • Must be 18 years of age.
  • Must have a team-oriented mentality and be able to communicate effectively in a fast-paced Pharmacy environment.
Company Description
Specialty Pharmacy with a focus on advanced disease states and outstanding patient care. Please visit pfsprx.com for additional information on what our Company is all about!

PFSP Specialty Pharmacy

Specialty Pharmacy with a focus on advanced disease states and outstanding patient care. Please visit pfsprx.com for additional information on what our Company is all about!

Address

398 W Grand Ave

Rahway, NJ
USA
View all jobs at PFSP Specialty Pharmacy