Top 9 Prior authorization specialist Jobs in Omaha, Ne

Pharmacy & Medical Benefits Verification Specialist (Amber Specialty Pharmacy)
Amber Specialty Pharmacy —Omaha, NE
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
9d
Pre-Authorization Specialist
Think Whole Person Healthcare —Omaha, NE
- Full-time
- Mid-level
- 2 years
Quick Apply
Home Health Intake Specialist
Children's Nebraska —Omaha, NE
- Full-time
- Writing skills
- 3 years
- Finance
12d
Access Scheduler
Nebraska Methodist Health System —Council Bluffs, IA
- Full-time
- Acute care
- Hospital
- HIPAA
Client Support Specialist II
Farm Family —Omaha, NE
- Overtime
- Mid-level
- Office
- High school diploma or GED
- Health insurance
- Dental insurance
Specialist, Bank Identified Fraud Intake - $20/HR (Omaha, NE Only)
First National Bank of Omaha —Omaha, NE
- Email
- Spanish
- English
- Office
- Health savings account
- Disability insurance
8d
Sr. Specialist, Customer Solutions
First National Bank of Omaha —Omaha, NE
- Email
- Hybrid work
- Microsoft Excel
- Mid-level
- Office
- Health savings account
- Disability insurance
12d
Patient Support Specialist
Total Respiratory & Rehab —Omaha, NE
- Overtime
- Background check
- Microsoft Outlook
- Ability to walk for extended periods
Quick Apply

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Pharmacy & Medical Benefits Verification Specialist (Amber Specialty Pharmacy)
Amber Specialty Pharmacy —Omaha, NE
Notifies appropriate staff of relevant information gathered during calls to provider or patient that may affect a patient’s disease state, medication regimen or…
9d
Pre-Authorization Specialist
Think Whole Person Healthcare —Omaha, NE
Professionally respond to all telephone calls, emails, internal messages, EHR requests in a timely manner to ensure patients’ needs are met prior treatment.
Quick Apply

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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
Quick Apply
11d
Prior Authorization Specialist
Equitas Health, Inc. —Columbus, OH
Reliable transportation, driver’s license and proof of auto insurance required. Essential job functions include, but are not limited to, driving or having…
$18.13 - $21.78 an hour
Quick Apply

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Pharmacy & Medical Benefits Verification Specialist (Amber Specialty Pharmacy)

Amber Specialty Pharmacy -
Omaha, NE

Apply Now

Job Details

Full-time
9 days ago

Benefits

Paid holidays

Qualifications

High school diploma or GED

Full Job Description

Additional Considerations (if any):

At Amber Specialty Pharmacy, our commitment to patient care is unmatched. Enjoy fulfillment in a career where you have the opportunity to make a positive impact on patients with complex and chronic conditions.

Monday-Friday (NO WEEKENDS!)
Hours: 7 am - 7 pm CST; varied shifts (to equal 40 hours per week)
Six paid holidays
Must pass post-offer, pre-employment drug background tests as allowed by state, federal, local ordinance, statutes and licensing/accreditation requirements.

Amber Specialty Pharmacy

Job Title : Benefits Specialist

Department: Operations

FLSA: Non-Exempt

General Function:

Responsible for ensuring accurate insurance information is received, stored and current benefits are verified upon receipt of new and/or renewal referrals for patients. This is inclusive of a thorough pharmacy and medical benefits investigation to determine appropriate and accurate coverage of the prescribed medication to ensure the Company will be reimbursed at maximum allowable rates and in a timely manner.

Reporting Relations:

Accountable and Reports to: Lead Benefits Specialist, Senior Manager - Revenue Cycle

Positions that Report to you: None

Primary Duties and Responsibilities:

This is an office-based position.
Working knowledge of all necessary computer software to perform job duties. Enters data requirements accurately and efficiently into tracking software.
Maintains documentation of calls to and from patients, caregivers, insurance companies, providers and Pharma (if applicable).
Notifies appropriate staff of relevant information gathered during calls to provider or patient that may affect a patient’s disease state, medication regimen or method of funding.
Knowledge of primary code classifications: ICD-10, CPT and HCPCS.
Knowledge of general Commercial insurance benefits, Medicare Part D benefit structure, Medicaid FFS and Managed Care Organizations and medical insurance benefit designs.
Must be able to perform complete benefits investigation, including prior authorization and medical vs pharmacy determination. The individual will also need to complete all payer documentation including Medicare Certificates of Medical Necessity and DME Information Forms.
Knowledge of pharmacy processing system to prepare and transmit eligibility inquiries to determine coverage.
Acts as a liaison between the Company, insurance companies, co-pay assistance sources and provider’s offices via phone, fax and e-mail communications.
Creates patient’s estimated cost of benefits with all pertinent information and attaches to record for use by Customer Care Center of Excellence.
Must maintain the established workflow within the Benefits Department and adhere to the company/department’s Policy and Procedure manual.
Responsible for coordinating manufacturer or nursing agency support when home teaching is required.
Contacts referring nurses/coordinators according to assigned team regarding insurance verification findings and patient issues and status updates.
Adheres to all company policies as indicated in the handbook and directives issued by management. Has reviewed Policy and Procedure manual.
Preferred knowledge in State Renal Programs and their application to transplant and specialty patients.

Knowledge, Skills, Abilities, and Worker Characteristics:

Proficient with MS Excel, Word, and Outlook Demonstrated ability to meet tight deadlines.
Must be detail oriented with a high degree of accuracy and efficiency.
Ability to work as a team and with all levels of internal management and staff, as well as outside clients and vendors.

Education and Experience:

Working knowledge of the healthcare industry, specifically the pharmacy industry
HIPAA trained and /or the ability to work with and protect extremely confidential patient and employee information.
One (1) year experience in Benefits
High school diploma or equivalent

Physical Requirements:

Must be able to remain in a stationary position –up to 90% of the time
The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc., and traverse conferences, meetings, and remote events.
Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer.
The ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations.
The ability to observe details at close range (within a few feet of the observer).

Working Conditions:

Normal office environment.

Equipment Used to Perform Job:

Computers, keyboards, mouse, monitors, fax, and/or headsets for phone work. Software specific to the position, including but not limited to Microsoft Outlook and Skype. Must lift and traverse the area to move paper and supplies to use the equipment.

Contacts:

Frequently interact with co-workers, intradepartmental staff of the Company, managers, leaders, Vendors, and customers.

Confidentiality:

The position Interactions with medical personnel, patients, and accesses proprietary and medical (HIPAA) information in various interactions and matters.

This position is required to complete background checks, including drug testing, criminal conviction history, references, OIG, and other relevant information as allowed by city, state, agency, organizations, or federal requirements/law.

Candidates must be able to pass a pre-employment drug test, background check, and health screening (if applicable).

Apply now and join our mission to provide exceptional patient care!

Apply Now

Refine Your Search

prior authorization specialist jobs in omaha, ne

Pharmacy & Medical Benefits Verification Specialist (Amber Specialty Pharmacy)

Pre-Authorization Specialist

Home Health Intake Specialist

Access Scheduler

Client Support Specialist II

Specialist, Bank Identified Fraud Intake - $20/HR (Omaha, NE Only)

Sr. Specialist, Customer Solutions

Patient Support Specialist

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