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Jobs / Quality Assurance Specialist in United States of America
2 days ago
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Brightspring·2 days ago
2 days ago

Prior Authorization Specialist

DENVER, United States of AmericaMid · 2-5 years

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About this role

Our Company

Amerita

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 the prior authorization process.

 

Schedule:Monday - Friday 8 am-5:30 pm MST

 

We Offer:

• 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

About our Line of Business

Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit www.ameritaiv.com. Follow us on Facebook, LinkedIn, and X.  

Additional Job Information

Percentage of Travel:  0-25%

Salary Range

USD $22.00 - $30.00 / Hour
H1B sponsor likely
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