Top 1 Prior authorization specialist Jobs in Rutherford County Nc

Pharmacy Benefits Specialist
CAROLINA ASTHMA AND ALLERGY CENTER —Shelby, NC
- Full-time
- Customer service
- Office
- High school diploma or GED
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Prior Authorization Specialist
WSD —Westerville, OH
Must have prior experience with insurances and prior authorizations. Collaborate with clinical staff to ensure timely approvals for patient treatments.
$18 - $25 an hour
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8d
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
Associate's Degree required; Bachelor's Degree preferred in Healthcare Administration, Business Administration, Social Work, Public Health, or related field.
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3d

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Pharmacy Benefits Specialist

CAROLINA ASTHMA AND ALLERGY CENTER -
Shelby, NC

Quick Apply

Job Details

Full-time

Qualifications

Customer communication
Patient service
High school diploma or GED

Full Job Description

General Summary: A nonexempt position responsible to coordinate the activity of pharmaceuticals, such as Xolair, for the practice. These responsibilities will include: Appointment scheduling; Obtaining prior authorizations; Ordering; Inventory tracking & reconciliation; Collecting patient-due amounts; and other needed tasks

Essential Job Responsibilities:

Determine if the pharmaceutical should be handled as Buy & Bill or Specialty Pharmacy
Obtain pre-authorization for drug purchase
Order pharmaceutical from the drug company
Assist patient with copay assistance
Provide estimates to patients on their financial responsibility
Checks and balances to verify that we are ordering and billing correctly
At the end of each day run scheduling and charge reports to ensure that Buy & Bill and Specialty Pharmacy injections have been billed appropriately
Collect patient-due amounts
Accounts Receivables - follow up, denials monitoring and appeals
Monitor and track drug inventory per location
Other tasks as requested by supervisor

Education: High school diploma or equivalent.

Experience: At least 1 year of insurance verification, and charge auditing

Other Requirements: None

Performance Requirements:

Skills:

Ability to multi-task
Attention to detail
Ability to read accounts and understand medical terms
Excellent customer service and communication skills
Exhibit high level of professional behavior
Ability to learn quickly and work well under pressure
Ability to work independently and as a team

Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.

Work Environment: Position is in a well-lighted office environment.

Mental/Physical Requirements: Involves sitting approximately 90 percent of the day, walking or standing the remainder.

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prior authorization specialist jobs in rutherford county nc

Pharmacy Benefits Specialist

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