Prior Authorization Specialist – Specialty Pharmacy Job Vacancy in PFSP Specialty Pharmacy Rahway, NJ 07065 – Latest Jobs in Rahway, NJ 07065
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Company Name : PFSP Specialty Pharmacy
Location : Rahway, NJ 07065
Position : Prior Authorization Specialist – Specialty Pharmacy
Job Description : Specialty Pharmacy seeks bright, articulate, positive-minded and energetic Pharmacy Prior Authorization (PA) Specialist. We offer a competitive salary, benefit package including vacation, paid major holidays, health insurance, 401K with company match and room for growth!Prior Authorization Specialist will be responsible for obtaining prior authorizations and appeals (as required) for a Specialty Pharmacy.The Pharmacy Prior Authorization (PA) Specialist processes written and telephone requested services by providers for PFSP Specialty Pharmacy within established time frames, following PFSP criteria and guidelines. This position also completes data entry and provider notification to ensure timely service to patients.This position is primarily responsible for working prescriptions specifically related to specialty pharmacy for various complex disease states, obtaining prior authorization from intermediaries and payers, including managed care companies, insurance companies. This position requires an enhanced level of knowledge for specific disease states to maximize revenue capture for high-cost medications and complex disease states.Demonstrates working knowledge of all facets of role, relevant regulations, and organizational and departmental policies and procedures. Performs other duties and projects as assigned. Performs all duties in accordance with regulatory requirements and organizational policies and procedures.Responsibilities will include:Obtaining prior authorizations from intermediaries and payersExperience in PA’s for complex disease state medications is a plus – Onco, Nuero, HCV, HIVHighly motivated team player with a positive attitude and the ability to self-direct and prioritize.Physician & patient contact.Medical billing experience is required for this position.Maintaining accurate reporting via dispensing software/Excel workbooks and other duties as assigned.Extensive knowledge of Microsoft Excel/Word a must.New Leaf and Therigy experience is a plus.Must have a team-oriented mentality and be able to communicate effectively in this fast-paced Pharmacy environment.Job Requirements:This is a full-time hourly position.Experience in completing prior authorization forms requiredMinimum of one year in a similar operation required (health insurance, healthcare, specialty pharmacy and/or managed care arena)Medicaid/Medicare experience requiredPharmacy call center experience or one year relevant experience preferredHighly motivated team player with a positive attitude and the ability to self-direct and prioritize.Must have a high school diploma or equivalent.Must be 18 years of age.Must have a team-oriented mentality and be able to communicate effectively in a fast-paced Pharmacy environment.Job Type: Full-timePay: $24.00 – $28.00 per hourBenefits:401(k)401(k) matchingDental insuranceFlexible spending accountHealth insurancePaid time offVision insuranceSchedule:8 hour shiftMonday to FridayCOVID-19 considerations:PFSP cares about our team members! We take all of the necessary precautions to ensure that we provide a safe working environment for everyone @ PFSP.Application Question(s):Do you have experience processing prior authorizations for specialty medications in any of these complex disease states: Oncology, Neurology, Hepatitis, HIV, Rheumatology, or Dermatology?Education:High school or equivalent (Preferred)Experience:Prior Authorization: 1 year (Preferred)Work Location: One location
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