Top 11 Prior authorization specialist Jobs in Menomonee Falls, Wi

Pharmacy Tech- Medication Access Specialist- 1.0 FTE- Days
ProHealth Care —Waukesha, WI
- Temporary
- Microsoft Word
- Customer service
- Entry level
- Health savings account
- Tuition reimbursement
7d
Intake Specialist
Wellpoint Care Network —Milwaukee, WI
- Online Application
- Vital signs
- Microsoft Outlook
- Medical office experience
Quick Apply
Clinic Service Representative - Westbrook
Children's Wisconsin —Brookfield, WI
- Part-time
- HIPAA
- High school diploma or GED
- Clinic
11d
Clinical Referral Specialist
Sixteenth Street Community Health Centers —Milwaukee, WI
- Full-time
- Spanish
- Current TB test
- Computer literacy
Quick Apply
Therapy Care Specialist - Specialty Infusion Pharmacy Technician
Soleo Health Inc —Pewaukee, WI
- Urgently hiring
- Microsoft Word
- Microsoft Outlook
- Mid-level
- Paid parental leave
- Health savings account
Quick Apply
10d
Clinic Svc Rep
Children's Wisconsin —Delafield, WI
- Part-time
- HIPAA
- High school diploma or GED
- Clinic
4d
Clinic Service Representative - Bayshore
Children's Wisconsin —Fox Point, WI
- Full-time
- HIPAA
- High school diploma or GED
- Clinic
13h
Customer Support Spec
DYNATECT MANUFACTURING INC —New Berlin, WI
- Computer literacy
- Writing skills
- Basic math
Quick Apply
15h
Digital Banking Specialist
Citizens Bank - WI —Mukwonago, WI
- $20 - $26 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Computer literacy
- Health savings account
- Health insurance
Quick Apply
10d

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Responds to patient calls about how out of network insurance is handled and provide patient with letter explaining this if necessary.
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prior authorization specialist jobs near menomonee falls, wi

Pharmacy Tech- Medication Access Specialist- 1.0 FTE- Days

ProHealth Care -
Waukesha, WI

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Job Details

Temporary | Full-time
7 days ago

Benefits

Health savings account
Tuition reimbursement
Paid time off
401(k) matching

Qualifications

Microsoft Word
Customer communication
Spreadsheets
Word embeddings

Full Job Description

Location: N16 W24131 Riverwood Drive, Waukesha WI 53188, United States Job Type: Days - 1st Shift Job ID: 112723

Ready to apply? You have options. For a faster and easier application & interview scheduling process, Chat with Olivia, our AI Recruiting Assistant. You'll answer a few quick questions and be done in minutes. Or, submit a Standard Application.

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We Are Hiring: Pharmacy Tech- Medication Access Specialist- 1.0 FTE- Days

Begin your story with ProHealth Care. Here we offer a culture that's warm, welcoming, and vibrant. Additionally, we offer a generous benefits plan and resources to help you further your education. After all, it's the way you should be treated. Enjoy our video series featuring our own employees sharing why they choose ProHealth Care and what they enjoy about working here.

Culture is built every day, and we want you to be a part of this. If you're like us and are passionate about providing exceptional patient care, we'd like to meet you!

Schedule Details: This 1.0 FTE commits to 40 hours per week. This position is M-F 8-4:30, No holidays, or weekends.

This is not a seasonal or temporary position.

What You Will Do:

The Medication Access Specialist is a patient-facing position focused on seeking grants, disease-specific foundation and/or pharmaceutical sponsored copay assistance or free medication programs to offset patient financial toxicity from oral and injectable therapies including chemotherapy/biotherapy and support medications. Additionally, will coordinate with insurer directed prior authorization for Specialty Pharmacy fulfillment, the patient and the clinical team.

Responsibilities:

Supports ProHealth Care Mission and Value statements, including compliance with USP 797 and 800 guidelines, TJC standards, Federal and State Laws and Regulations.

Demonstrates exceptional interpersonal and customer service skills in all interactions with patients as well as internal and external healthcare team members.

Ensures all demographic, insurance, and eligibility information is obtained and up-to-date

Perform insurance verification in a timely manner for initial and subsequent pre-authorizations with all third-party payers for oral chemotherapy and other therapies to minimize disruption to care

Interacts with prescribers (or team) to obtain appropriate clinical documentation to ensure accurate indications from EMR prior to completion of third party prior authorizations.

Maintaining up-to-date knowledge of requirements for enrolling patients in: manufacturer, state, and local medication assistance programs; disease-specific assistance grants from non-profit organizations (foundations).

Document in electronic medical record all prior authorization of medications that ensures accuracy and within the date range and quantity of medication received.

Working collaboratively with the healthcare team (nurses, physicians, pharmacists, others) to obtain clinical and financial information for timely copay and medication assistance program enrollment for oral and injectable therapies including chemotherapy/biotherapy and support medications

Working with patients and their family/caregivers to apply to the programs for which they qualify.

Assisting with applications for patient assistance and co-pay programs to ensure demographic, insurance, and eligibility information is current.

Obtaining patient financial records (as needed/required for eligibility)

Liaising between the patient, the clinical program (i.e. Cancer, etc.), and the patient assistance program(s).

Utilize tools to manage and track all financial assistance obtained, metrics, and patient interactions with governmental and non-governmental payer(s), as well as patient assistance, drug replacement, and grant or foundation programs

Willingness to train new hires/existing employees on process and procedure

Collaborate on pharmacy SOP, Policy and Procedure development (Retail and Hospital)

Communicate and collaborate with PHC Specialty/Retail Pharmacies for dispensing of oral and self-injected medications

Organizes procurement of medications and supplies for the pharmacy

Requirements:

PTCB Pharmacy Technician Certification preferred upon hire or within 2 years of hire.

2 years of pharmacy technician experience preferred.

Basic competency using Microsoft Excel and Word.

Prior experience obtaining prescription prior authorizations preferred.

Completes organizational, departmental and job specific competencies, as assigned

Why Join ProHealth Care:

We have nearly 5,000 dedicated clinical and non-clinical employees and physicians who work together every day to serve the health and well-being of our community. At ProHealth Care everyone contributes to the care our patients receive. And, everyone is treated with kindness and respect in our welcoming environment.

This Position Will Offer You:

Engaging and community focused culture
Competitive Salaries
Opportunity for professional career growth
Robust benefits for full-time and regular part-time roles, including Generous PTO; Choices in insurance; HSA; Tuition reimbursement; immediate 401K match; discounted tickets to various entertainment, social, and sporting events

ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

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Refine Your Search

prior authorization specialist jobs in menomonee falls, wi

Pharmacy Tech- Medication Access Specialist- 1.0 FTE- Days

Intake Specialist

Clinic Service Representative - Westbrook

Clinical Referral Specialist

Therapy Care Specialist - Specialty Infusion Pharmacy Technician

Clinic Svc Rep

Clinic Service Representative - Bayshore

Customer Support Spec

Digital Banking Specialist

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