Prior Authorization Specialist
HybridLouisville, Kentucky, United States
Louisville, Kentucky, United StatesHybridFull TimeEnterprise
Full TimeEnterprise
Job Summary
Complete pharmacy claims prior authorizations or coordinate therapy changes with prescribers and facility contacts within four to five business days. Ensure accurate paperwork completion by tracking unbilled claims in QuickBase, sending weekly Excel reports to the Director of Pharmacy, and resolving claim rejections. Assist the Billing Department with month-end close tasks and advocate for clients as needed. Utilize Frameworks, QuickBase, Docutrack, and CoverMyMeds to manage daily workflows. Work Mon-Fri (8:30am to 5pm) in Louisville, KY, with a hybrid schedule available after training.
Required Qualifications
- High School Diploma/General Education Diploma
- Proficient with Microsoft Word & Excel
- Ability to prioritize and meet pre-determined deadlines
- Must be able to effectively multi-task
- be proficient at typing
- have advanced technical skills
- Experience in healthcare billing environment
- Familiarization with on-line claims processing
- Familiarization with Medicaid and Medicare billing practices
Desired Qualifications
- Kentucky Pharmacy Technician License
- experience in healthcare billing environment (pharmacy preferred)
- Excellent customer service and communication skills, both written and verbal
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