Pharmacy Prior Authorization Specialist (Flagstaff, Az)

North Country HealthCare is transforming health care for rural Arizona as a Primary Care, Federally Qualified Teaching Health Center. We provide Family Medicine, Pediatrics, Obstetrics/Gynecology, Dental, Physical Therapy, and Behavioral Health services to the under-served population throughout northern Arizona. We believe in practicing integrative care in an inclusive culture. We treat some of the most vulnerable rural populations in the United States while supporting North Country's mission. We are proud of our Family Medicine Physician Residency, our medical education programs, and our passionate team.
DESCRIPTION OF POSITION
Promotes the mission and vision of North Country HealthCare (NCHC) by being responsible for providing accurate and complete data input for Prior Authorization requests and for managing all Prior Authorizations to the point of resolution. This is achieved through collaborative practice with others on the health care team both internal and external to NCHC. This position will be responsible for the on-boarding of all outlying clinics in an organized fashion.
ESSENTIAL DUTIES AND RESPONSIBILITIES

• Answer calls from providers, insurance companies and patients using exemplary customer service skills.
• Accurately enter required information (non-clinical and structured clinical data) into computer database.
• Review structured clinical data matching against specified medical terms and diagnoses or procedure codes (without need for interpretation) and follow established procedures for completion of requests.
• Call patients when results of Prior Authorization are determined per established procedures.
• Call pharmacies with authorization numbers/authorization information when it becomes available.
• Follow-up with any outstanding Prior Authorizations on a regular basis.
• Establish and maintain a procedure of documentation of Prior Authorization process.
• Maintain patient confidentiality as defined by state, federal and company regulations.
• Establish effective rapport with other employees from outlying clinics and maintain strong communication.

REQUIRED CERTIFICATES, LICENSES, REGISTRATIONS

• High school diploma.
• Certified Pharmacy Technician (CPhT) or other health professional training (e.g. medical assistant or licensed practical nurse).
• Pharmacy Technician Certification (PTCB) or equivalent professional licensure.

PREFERRED CERTIFICATES, LICENSES, REGISTRATIONS
Four Year Bachelor Degree in related field with experience in Pharmacy
OTHER DESIRABLE QUALIFICATIONS

• Comfortable working independently in an outpatient care setting.
• One or more years working in a community health setting.
• Demonstrated cultural competency to work in low income, minority environment.
• Experience with data entry in various systems including electronic health record system, pharmacy software (QS1) and covermymeds.com.
• Bilingual (Spanish and English).
• Prior authorization experience preferred.

BENEFITS

• Health Insurance starts on day one, as little as $5 per paycheck
• Dental, Vision, 401K Matching, Employee Assistance Program
• Up to 7 weeks of combined Paid Time Off including sick pay, federal & floating holidays within the first year, Accrual starts on Day 1
• No nights or Weekends
• Loan Repayment and Tuition Reimbursement Programs
• Career growth and Professional Development

COMPENSATION
Starting at $21.63+ DOE
North Country is a VEVRAA Federal Contractor and Equal Opportunity Employer.