PRIOR AUTHORIZATION COORDINATOR II

Our Company
Pharmacy Alternatives
Overview
Pharmacy Technician License Fees: We've Got You Covered!
New hires and current employees are eligible for reimbursement for license fees as required.
Location: Hybrid (on-site Wednesdays) **MUST BE LOCAL TO LOUISVILLE KY**
Hours: Monday - Friday 8:30am to 5:55pm
Required experience/skills: Pharmacy Technician
Benefits Offered Include:

• DailyPay
• Flexible schedules
• Competitive pay
• Health, dental, vision and life insurance benefits
• Company paid STD and LTD
• Tuition Assistance
• Employee Discount Program
• 401k
• Paid time off
• Tuition reimbursement

Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!
Responsibilities
The Prior Authorization Coordinator II is responsible for striving to complete either approval for pharmacy claims requiring PRIOR AUTHORIZATION or coordinating with prescribers and/or facility contacts to have therapy changed to a preferred alternative due to insurance not covering the treatment in question. The PA Coordinator II also completes the onsite training of new hires as needed.

• Ensures accurate and timely completion of client PRIOR AUTHORIZATION and/or change of therapy paperwork by collaborating with prescribers and facility contacts
• Follows up on all claims requiring PRIOR AUTHORIZATION within 4-5 business days
• Tracks and reviews all claims in PowerApps and sends Excel tracking spreadsheet to Director of Pharmacy on weekly basis
• Compares system report of unbilled claims requiring prior approval to PowerApps tracking system to ensure any claim requiring PRIOR AUTHORIZATION is being followed up on
• Assists Billing Department with resolving unbilled claims at each month end close
• Advocates for clients as needed
• Support for Pharmacy Operations
• Adjudicates and resolves claim rejections as needed
• Utilizes Frameworks, PowerApps, Docutrack, and CoverMyMeds to complete workflow on daily basis
• Provides onsite training for new hires
• Maintains and updates the Prior Authorization Training Manual
• Performs other responsibilities as assigned

Qualifications

• High School Diploma/GED required
• Pharmacy Tech License preferred
• Excellent customer service and communication skills, both written and verbal
• Ability to prioritize and meet pre-determined deadlines
• Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
• Experience in healthcare billing environment (pharmacy preferred)
• Familiarization with online claims processing and Medicaid and Medicare billing practices
• Proficient with Microsoft Word and Excel required
• If a current PAL employee, you must:
  • Have 6+ months of PRIOR AUTHORIZATION experience as PAL Core Prior Authorization Coordinator
  • Adhere to Pharmacy Alternatives, LLC attendance policy
  • Excel and adhere to core Pharmacy Alternative Prior Authorization responsibilities
  • Not be on any form of Performance Improvement/Corrective Action Plan

About our Line of Business
Pharmacy Alternatives®, a PharMerica company, is a specialized pharmacy provider focused on serving individuals with cognitive, intellectual and developmental disabilities (I/DD) helping people live their best life. Pharmacy Alternatives combined with PharMerica offer unmatched long-term pharmacy solutions specializing in serving special-needs populations who live in intermediate care facilities, waiver homes, group homes, assisted living, supported-living or foster care. PharMerica is one of the nation's largest pharmacy companies. The combined organization offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades. For more information about Pharmacy Alternatives, please visit www.palrx.com. Follow us on Facebook and LinkedIn.