Top 75 Pharmacy specialist Jobs in Ca

Prior Authorization Specialist
California Specialty Pharmacy,LLC —California
- Full-time
- Remote
- Microsoft Word
- Microsoft Excel
- HIPAA
Quick Apply
Oncology Clinical Pharmacy Specialist
Shields Health Solutions —Fullerton, CA
- $150,000 - $190,000 a year
- Hybrid work
- Microsoft Outlook
- 3 years
- Data entry
- Paid parental leave
- Paid holidays
Quick Apply
12d
Sr. Specialist-Pharmacy Informaticist - Sharp System Pharmacy Services - Variable Shift - Full Time
Sharp HealthCare —San Diego, CA
- $83.97 - $121.36 an hour
- 8 hour shift
- Word processing
- Office
- Senior level
12d
Drug Utilization Management Specialist - Pharmacy 500P (Full-Time, 8-Hour Day Shifts)
Stanford Health Care —Palo Alto, CA
- $83.98 - $111.27 an hour
- 8 hour shift
- 5 years
- Analysis skills
- Supervising experience
Clinical Pharmacy Specialist II Oncology $20K Hiring Incentive
Palomar Health —Escondido, CA
- $71.94 - $108.07 a day
- 8 hour shift
- Computer literacy
- English
- Mid-level
Quick Apply
Pharmacy Technician Specialist – Medication History – Varied – La Jolla
Scripps Health —La Jolla, CA
- $29.73 - $41.71 an hour
- Full-time
- Acute care
- Surgery
- Inpatient
Pharmacy Specialist-Clinical (Infectious Disease Inpatient)
Loma Linda University Health —Loma Linda, CA
- $74.40 - $100.07 an hour
- Full-time
- Basic math
- Inpatient
- Mid-level
4d
Pharmacy Program Specialist - Pharmacy
Providence —Santa Monica, CA
- $29.62 - $45.31 an hour
- Full-time
- Maintenance
- Mid-level
- 3 years
- Paid parental leave
- Paid holidays
5d
Business Pharmacist Specialist - Specialty Pharmacy - (Full-Time/Hybrid, 8-Hour Day Shifts)
Stanford Health Care —Palo Alto, CA
- $74.73 - $99.04 an hour
- 8 hour shift
- Microsoft Excel
- Microsoft Outlook
- 5 years
Home Infusion Intake Specialist
UC Davis Health —Sacramento, CA
- $30.65 - $38.10 an hour
- 8 hour shift
- Background check
- Customer service
- Writing skills
- Continuing education credits
- Paid holidays
5d
Pharmacy Technician Specialist - Ambulatory - Mercy San Diego
Scripps Health —San Diego, CA
- $29.73 - $41.71 an hour
- 8 hour shift
- Hospital
- Customer service
- Mid-level
12d
Clinical Pharmacist Specialist
City of Hope —Irvine, CA
- $78.02 - $124.83 an hour
- Full-time
- Hospital
- BLS Certification
- Senior level
Y AS-NEEDED - Pharmacy Services Specialist
CalOptima —Orange, CA
- Weekends as needed
- Background check
- Spanish
- Microsoft Outlook
4d
Pharmacist - Pharmacogenomics Specialist
Cedars-Sinai —Beverly Hills, CA
- $164,028.80 - $262,454.40 a year
- 8 hour shift
- Hybrid work
- Computer literacy
- BLS Certification
- Patient care
- Dental insurance
- Vision insurance
Pharmacist Clinical Specialist, Transplant Services: Abdominal Transplant Administration
Hoag Health System —Newport Beach, CA
- Full-time
- Hospital
- BLS Certification
- Inpatient
Clinical Pharmacy Specialist
Doctors Medical Center of Modesto —Modesto, CA
- Full-time
- Acute care
- Psychiatry
- Hospital
- Health savings account
- Health insurance
Cardiology Account Specialist - Fresno, CA
MannKind Corporation —Fresno, CA
- $112,000 - $168,000 a year
- Call employer
- 5 years
- Bachelor's degree
- Continuous improvement
Quick Apply
7d
Clinical Pharmacist Specialist-IDS
City of Hope —Duarte, CA
- $78.02 - $124.83 an hour
- Full-time
- BLS Certification
- Clinic
- Senior level
Ambulatory Care Pharmacy Specialist
Salinas Valley Health —Salinas, CA
- $83.86 - $104.83 a day
- Full-time
- BLS Certification
- Mid-level
- Outpatient experience
Pharmacist Specialist, Pharmacy (Per Diem, Day Shift)
Adventist Health —Bakersfield, CA
- $77.28 - $105.99 an hour
- Day shift
- Hospital
- Inpatient
- Mid-level
10d

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Prior Authorization Specialist

California Specialty Pharmacy,LLC
California

Quick Apply

Job Details

Full-time

Qualifications

Microsoft Word
Microsoft Excel
Overseeing health insurance pre-certification
Serving clients
Presentation software

Full Job Description

Continuumrx is currently recruiting employees in Birmingham, Alabama to support our Acute Authorization and Verification Team!

Job Summary:

The Verification Specialist - Specialty role is responsible for processing benefit verification of benefits for acute patients.
The primary role of the Authorization Specialist is to review, process, and follow to completion the requirement of obtaining prior authorizations for services. This includes PBM authorizations.

Verification Specialist Roles and Responsibilities:

Verifies benefit coverage and as appropriate, financial responsibility.
Identifies out-of-pocket co-pays, deductibles, and co-insurance prior to services rendered in accordance with the insurance eligibility/coverage information provided by payor at time of insurance verification.
Documents all patient interaction in EMR as a billing note.
Serves as a resource and problem resolution expert for patients, Intake and Sales.
As needed, verifies insurance coverage and eligibility through payor websites, E1 check, or by calling the payor directly. Document information in EMR and communicates as appropriate to team members.
Assists with Ready To Bill (RTB) as appropriate.
Performs other duties and special projects, as assigned.
Complete understanding of confidentiality with respect to Company proprietary information as well as information concerning patient/client care; complying with all federal and state laws as apply to confidentiality of protected health information (PHI) and electronic protected health information (EPHI); and following HIPAA guidelines regarding readily identifiable protected health information.

AuthorizationSpecialist Roles and Responsibilities:

Coordinates with the Intake Specialists and the Pharmacy Team to identify and process requests for services requiring Prior Authorization and/or Pre-Determination for services rendered.
Reviews each request for Prior Authorization and insures that the proper supporting documentation and forms/documents are completed.
Processes Prior Authorizations via Fax, computer or phone call as required by the specific payers.
Maintains an organized process for documenting and tracking all requested prior authorizations.
Maintains an organized process for timely follow-up and troubleshooting of all pending Prior Authorizations.
Documents in the patient record all prior authorizations, expiration dates and other information as required.
Communicates with the Revenue Cycle Team and Admission Specialists any prior authorization denials and insures prompt follow-up.
Maintains a process to review newly accepted patients for a “second check” to prevent missing prior authorization requests.
Effectively identify and communicate to supervisor when assistance is needed (including, but not limited to system function, training, etc.).
Observes legal and ethical guidelines for safeguarding patient and company confidentiality (HIPAA).
Understands and provides exceptional customer service to clients, patients, and payers.
Exhibits a positive, courteous, respectful and helpful attitude to clients, co-workers, and management team.
Promotes company culture by adhering to all policies and procedures.
Adapts to and demonstrates the ability to deal with frequent changes in the work environment.
Other tasks/duties as assigned.
Complete understanding of confidentiality with respect to Company proprietary information as well as information concerning patient/client care; complying with all federal and state laws as apply to confidentiality of protected health information (PHI) and electronic protected health information (EPHI); and following HIPAA guidelines regarding readily identifiable protected health information.

Qualifications and Experience:

Required:

2 or more years of experience in healthcare reimbursement with focus on insurance verification and authorizations.
Experience with coordination of benefits, including but not limited to HMO, PPO, TPA, state and federal payors; preferred but not required.
Prior work in specialty or home infusion, homecare or related field; preferred but not required.
Strong computer skills (Microsoft Word, Excel, PowerPoint)
Exceptional communication - verbal and written
Exceptional interpersonal skills
Exceptional organizational and process skills
Ability to work well under pressure, meet timelines, and completes assigned projects
Exceptional critical thinking and problem solving skills
Proven performance, history in related field Exceptional attention to detail and demonstrated results
Exceptional track record of customer satisfaction

Quick Apply

Refine Your Search

pharmacy specialist jobs in ca

Prior Authorization Specialist

Oncology Clinical Pharmacy Specialist

Sr. Specialist-Pharmacy Informaticist - Sharp System Pharmacy Services - Variable Shift - Full Time

Drug Utilization Management Specialist - Pharmacy 500P (Full-Time, 8-Hour Day Shifts)

Clinical Pharmacy Specialist II Oncology $20K Hiring Incentive

Pharmacy Technician Specialist – Medication History – Varied – La Jolla

Pharmacy Specialist-Clinical (Infectious Disease Inpatient)

Pharmacy Program Specialist - Pharmacy

Business Pharmacist Specialist - Specialty Pharmacy - (Full-Time/Hybrid, 8-Hour Day Shifts)

Home Infusion Intake Specialist

Pharmacy Technician Specialist - Ambulatory - Mercy San Diego

Clinical Pharmacist Specialist

Y AS-NEEDED - Pharmacy Services Specialist

Pharmacist - Pharmacogenomics Specialist

Pharmacist Clinical Specialist, Transplant Services: Abdominal Transplant Administration

Clinical Pharmacy Specialist

Cardiology Account Specialist - Fresno, CA

Clinical Pharmacist Specialist-IDS

Ambulatory Care Pharmacy Specialist

Pharmacist Specialist, Pharmacy (Per Diem, Day Shift)

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