Top 33 Prior authorization specialist Jobs in Coral Gables, Fl

Medication Access Specialist - Pharmacy Technician - FT - Days - MSP
Memorial Healthcare System —Miramar, FL
- Full-time
- Customer service
- Data analysis skills
- Mid-level
Pharmacy Medication Assistance Liaison, Specialty Pharmacy, Per Diem,Varies
Baptist Health South Florida —Miami Lakes, FL
- Per diem
- Customer service
- 5 years
- Research
- Wellness program
- Health insurance
Patient Access Specialist (Remote) – Full Time
University of Miami —Miami, FL
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
9d
Patient Transfer Center Associate, Full Time, Nights (9pm - 730am)
Jackson Health —Miami, FL
- Full-time
- Hospital
- Inpatient
- Residential
Quick Apply
Patient Transfer Center Associate, Full-Time, Nights, 7:00pm-5:30am
Jackson Health —Miami, FL
- Full-time
- Inpatient
- Residential
- High school diploma or GED
Quick Apply
3d
Patient Access Representative Specialist (Onsite) (H))
University of Miami —Coral Gables, FL
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Prior Authorization Certified Pharmacy Technician
Shields Health Solutions —Miami, FL
- $19.45 - $22.21 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- Research
Quick Apply
Medical Office Specialist
HCA FL Weight Mgmt & Metabolic Wellness —Miami, FL
- Full-time
- Surgery
- Mid-level
- Cardiology
- Employee stock purchase plan
- Disability insurance
Quick Apply
Medical Records Technician (ROI)
US Veterans Health Administration —Miami, FL
- $48,361 - $62,869 a year
- Part-time
- Background check
- High school
- Writing skills
- Paid parental leave
- Paid holidays
1d
Patient Access Specialist (On-Site) (H)
University of Miami —Doral, FL
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Patient Access Specialist (On-Site)
University of Miami —Miami, FL
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Patient Access Specialist (On-Site) - Full Time - Bascom Palmer Eye Institute Doral, Fl
University of Miami —Doral, FL
- Weekends as needed
- Computer literacy
- HIPAA
- Mid-level
- Health insurance
- Dental insurance
Remote ABA Therapy Medical Billing Specialist
House of Hearts ABA —Hollywood, FL
- $20 - $28 an hour
- Part-time
- Remote
- Bachelor's degree
- Children
- Organizational skills
Quick Apply
Medical Insurance Authorization Specialist
CordiCare —Davie, FL
- $20 - $24 an hour
- Full-time
- Spanish
- English
- Mid-level
- Paid holidays
- Paid time off
Quick Apply
4d
Patient Scheduler 2, Radiology, Full Time
University of Miami —Miami, FL
- Full-time
- Microsoft Access
- Microsoft Outlook
- Clinic experience
- Health insurance
- Dental insurance
Patient Access Specialist – UHealth SoLé Mia
University of Miami —North Miami, FL
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Pharmacy Technician - Medication Access Specialist - FT - Days - MSS
Memorial Healthcare System —Hollywood, FL
- Full-time
- Customer service
- Data analysis skills
- Mid-level
VOB & Collections Specialist
evolutions treatment center —Miami, FL
- From $20 an hour
- Full-time
- Addiction Medicine
- HIPAA
- Office
- Health insurance
- Dental insurance
Quick Apply
13d
INSURANCE VERIFICATION REPRESENTATIVE
Care Resource Community Health Centers, Inc. —Miami, FL
- Hybrid work
- Spanish
- Microsoft Excel
- Microsoft Outlook
Surgical Coordinator
Pelvic Rehabilitation Medicine —Miami, FL
- $24 - $28 an hour
- Full-time
- Surgery
- Physical & Rehabilitation Medicine
- Mid-level
Quick Apply
10d

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Medication Access Specialist - Pharmacy Technician - FT - Days - MSP

Memorial Healthcare System -
Miramar, FL

Apply Now

Job Details

Full-time

Qualifications

Pharmacy Technician License
PTCB Certification
High school diploma or GED
Registered Pharmacy Technician

Full Job Description

Location:

Miramar, Florida

At Memorial Healthcare System (MHS), our ever-growing pharmacy career options present unlimited opportunities to individuals passionate about advancing pharmacy practice. As a nationally recognized and respected leader for providing “A-rated” patient care and safety, MHS prides itself on being able to grow and adapt to the rapidly evolving needs of our community and healthcare industry.

Summary:

Responsible for performing benefit coverage investigations, initiating, processing, resolving prior authorizations (including denials), helping patients obtain financial assistance from pharmacy related services. Coordinates enrollment, utilization, and ongoing eligibility for manufacturer patient assistance programs to ensure access to medications and compliance with program requirements. Responsible preparing monthly pharmaceutical savings reports and responding to patient assistance program audits.

Responsibilities:

Performs pharmacy benefit investigation and applies knowledge and understanding of the coverage rules by third party payers, including Medicare and Medicaid. Identifies therapies that require certification of medical necessity. Works with providers and payers to obtain approval. Initiates support for appeals to denied authorizations for pharmacy services.Processes patient financial documentation for pharmacy financial assistance eligibility. Develops reimbursement payments schedules for patients with special needs. Tracks status of expiring reimbursements and processes renewals for patients as appropriate.Improves access to pharmaceutical therapy by performing pharmacy benefit investigation, prior authorizations, copay assistance, enrollment in manufacturer free drug programs, including medication replacement and appeals as appropriate.Tracks, trends and reports financial data related to drug reimbursement and replacement transactions.Coordinates receipt, delivery and distribution of free drug, drug replacements and bulk pharmaceuticals.Ensures compliance with financial and regulatory requirements. Coordinates and ensures appropriates credit to patient accounts when applicable.Assesses, assists and enrolls patients that require financial assistance for pharmacy services. Contacts pharmaceutical companies to obtain information and enrolls patients into pharmaceutical patient assistance programs. Monitors and coordinates re-enrollment or transition into additional pharmacy service lines.Participates in pharmacy reimbursement initiatives that increase patient access to pharmaceutical services and promotes cost savings to the health system.

Competencies:

ACCOUNTABILITY, ANALYSIS AND DECISION MAKING - PHAP, CUSTOMER SERVICE, FINANCIAL COUNSELING - PATIENT SERVICES, PATIENT AND FAMILY CENTERED CARE, PROBLEM SOLVING, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, VERIFY INSURANCE

Education and Certification Requirements:

High School Diploma or Equivalent (Required)Certified Pharmacy Technician (CPHT) - Pharmacy Technician Certification Board (PTCB), Registered Pharmacy Technician (RPT LICENSE) - State of Florida (FL)

Additional Job Information:

Complexity of Work: Requires critical thinking skills, effective communication skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.Required Work Experience: Three (3) years of pharmacy experience. Proficient understanding of the delivery of healthcare across multiple service lines.Other Information: Certified pharmacy technician through a nationally accredited organization.

Working Conditions and Physical Requirements:

Bending and Stooping = 80%
Climbing = 40%
Keyboard Entry = 80%
Kneeling = 40%
Lifting/Carrying Patients 35 Pounds or Greater = 0%
Lifting or Carrying 0 - 25 lbs Non-Patient = 80%
Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 60%
Lifting or Carrying > 75 lbs Non-Patient = 0%
Pushing or Pulling 0 - 25 lbs Non-Patient = 80%
Pushing or Pulling 26 - 75 lbs Non-Patient = 60%
Pushing or Pulling > 75 lbs Non-Patient = 40%
Reaching = 80%
Repetitive Movement Foot/Leg = 0%
Repetitive Movement Hand/Arm = 80%
Running = 60%
Sitting = 80%
Squatting = 80%
Standing = 80%
Walking = 80%
Audible Speech = 80%
Hearing Acuity = 80%
Smelling Acuity = 60%
Taste Discrimination = 0%
Depth Perception = 80%
Distinguish Color = 80%
Seeing - Far = 80%
Seeing - Near = 80%
Bio hazardous Waste = 40%
Biological Hazards - Respiratory = 40%
Biological Hazards - Skin or Ingestion = 40%
Blood and/or Bodily Fluids = 60%
Communicable Diseases and/or Pathogens = 40%
Asbestos = 0%
Cytotoxic Chemicals = 80%
Dust = 80%
Gas/Vapors/Fumes = 60%
Hazardous Chemicals = 80%
Hazardous Medication = 80%
Latex = 80%
Computer Monitor = 80%
Domestic Animals = 40%
Extreme Heat/Cold = 0%
Fire Risk = 40%
Hazardous Noise = 0%
Heating Devices = 60%
Hypoxia = 0%
Laser/High Intensity Lights = 0%
Magnetic Fields = 60%
Moving Mechanical Parts = 80%
Needles/Sharp Objects = 80%
Potential Electric Shock = 40%
Potential for Physical Assault = 0%
Radiation = 0%
Sudden Decompression During Flights = 0%
Unprotected Heights = 0%
Wet or Slippery Surfaces = 60%

Shift:

Days

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.

Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.

We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.

Employment is subject to post offer, pre-placement assessment, including drug testing.

If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email [email protected]

Apply Now

Refine Your Search

prior authorization specialist jobs in coral gables, fl

Medication Access Specialist - Pharmacy Technician - FT - Days - MSP

Pharmacy Medication Assistance Liaison, Specialty Pharmacy, Per Diem,Varies

Patient Access Specialist (Remote) – Full Time

Patient Transfer Center Associate, Full Time, Nights (9pm - 730am)

Patient Transfer Center Associate, Full-Time, Nights, 7:00pm-5:30am

Patient Access Representative Specialist (Onsite) (H))

Prior Authorization Certified Pharmacy Technician

Medical Office Specialist

Medical Records Technician (ROI)

Patient Access Specialist (On-Site) (H)

Patient Access Specialist (On-Site)

Patient Access Specialist (On-Site) - Full Time - Bascom Palmer Eye Institute Doral, Fl

Remote ABA Therapy Medical Billing Specialist

Medical Insurance Authorization Specialist

Patient Scheduler 2, Radiology, Full Time

Patient Access Specialist – UHealth SoLé Mia

Pharmacy Technician - Medication Access Specialist - FT - Days - MSS

VOB & Collections Specialist

INSURANCE VERIFICATION REPRESENTATIVE

Surgical Coordinator

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