Overview
Lumicera Health Services is seeking a Prior Authorization Specialist I to join our team! Under direction from the Supervisor, Specialty Pharmacy Services, and pharmacists in the Specialty Pharmacy, the Prior Authorization Specialist I is primarily responsible for obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy. The Prior Authorization Specialist's main objective is to answer phone calls and contact the doctors and patients via fax or phone or other communication means to facilitate and document prior authorization approval. The Prior Authorization Specialist may also be responsible for ensuring that all pertinent patient information is contained within the record. Patient information shall include demographics, allergies, medication history, comorbidities, and payer information. This position will function with and assist any other area in the facility as needed with regard to prior authorization type duties.
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Responsibilities
Answer inbound calls from patients, prescribers, and other healthcare professionals
Contact doctors to obtain necessary information
Manage the assigned workflow queues
Accurate and thorough documentation of information and prescription order setup
Act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee
Other duties as assigned
Qualifications
High school diploma or GED
Some college preferred
CPhT Preferred
Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure
Minimum two years pharmacy support experience or healthcare environment experience preferred
Ability to work scheduled hours, shifts may vary based on department needs. Hours of operation are 8am to 7pm Monday thru Thursday and 8am to 6pm on Friday
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
What can you expect from Navitus?
Top of the industry benefits for Health, Dental, and Vision insurance
20 days paid time off
4 weeks paid parental leave
9 paid holidays
401K company match of up to 5% - No vesting requirement
Adoption Assistance Program
Flexible Spending Account
Educational Assistance Plan and Professional Membership assistance