Non-Retail Authorization Management Specialist (Amber Specialty Pharmacy)
$39,520–$41,600 year
On-site · Omaha, Nebraska, United States
Job Summary
Dedicated Authorization Management Specialist at Amber Specialty Pharmacy, focusing on preparing prior authorizations and appeals for specialty pharmacy programs. Responsibilities include working with providers, health plans, PBMs, and other pharmacies to relay information, submitting PA/appeal requests via electronic, phone, or fax, maintaining PA/appeal documents and records, collaborating with program team members on patient access and onboarding, and advocating on the patient’s behalf to resolve coverage issues. Requires reviewing patient chart notes and payer requirements, ensuring timely and compliant PA requests, and adhering to company policies. Office-based role with emphasis on customer service, healthcare industry knowledge, HIPAA compliance, and proficiency in MS Excel/Word/Outlook; experience with Medicare/Medicaid/Commercial insurance and pharmacy-related processes is preferred.
Required Qualifications
- High school diploma or equivalent
- Six months or less of similar or related work experience
- HIPPA trained and/or ability to work with and protect highly confidential patient and employee information
- Nationally Certified Pharmacy Technicians preferred
- Proficient with MS Excel, Word, and Outlook
- Understanding of insurance verification and online prescription adjudication
- Strong oral, written, and interpersonal skills
- Ability to meet tight deadlines
- Working knowledge of Medicare, Medicaid, Commercial Insurance and renal programs related to pharmacy, billing, grants, copay cards, prior authorizations, and rejections
- Prior PAP, PA, and copay card experience preferred
- Proficiently read and understand abstract information from handwritten patient medical records
- Office-based environment experience
- Pre-employment drug test and background check requirements
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