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Orsini Specialty Pharmacy is Hiring a Remote Prior Authorization Specialist - Remote
Our MissionOrsini is on a mission to be the essential partner for biopharma innovators, healthcare providers, and payers to support patients and their families in accessing revolutionary treatments for rare diseases. Through our integrated portfolio of services, we seek to pioneer comprehensive solutions that simplify how patients connect to advanced therapies while providing holistic, compassionate care so that No Patient is Left Behind™.
LIVE IT ValuesAt the heart of our company culture, the Orsini LIVE IT core values serve as guiding principles that shape how we interact with each other and those we serve. These values are the driving force behind our commitment to excellence, collaboration, and genuine care in every aspect of our work.
Leading Quality, Integrity, Valued Partner, Empathy, Innovation, Team-FirstPosition SummaryThis position will work closely with the Benefits Verification Team to validate patient’s insurance plans, prescriptions, and eligibility. Job responsibilities include the ability to read prescriptions, convert prescriptions into authorizations and interpret medical policies. Prior Authorization Specialists are responsible for contacting physician’s offices to validate prescriptions, obtain clinical documentation and initiate prior authorizations through insurance plans.
Required Knowledge, Skills & Training
- Experience with Major Medical Insurance.
- Knowledge of Pharmacy Benefit
- Knowledge of HCPC Codes (J-Codes).
- Knowledge of ICD-10 Codes (Diagnoses Codes).
- Familiar with medical documentation such as H&P’s, Genetic testing, etc.
- Ability to read prescriptions.
- Ability to convert a prescription into an authorization request based on payer requirements.
- Ability to interpret medical policies.
- Prior pharmacy experience preferred
- Contact plans (PBM or Major Medical) to validate request sent from BV.
- Contact physician’s office to obtain current prescriptions.
- Contact physician’s office to obtain clinical documentation that is required by the plans.
- Validate that the clinical documentation received is what is required by the plan.
- Initiate prior authorizations through Cover My Meds.
- Follow up on all pending PA’s within 48 hours.
- Respond to urgent emails submitted by the PCC Team or Program Manager in a timely manner.
- Obtain approval/ denial letters.
- Submit all new Complex authorization approvals and/or Complex re -authorization approvals through the Complex audit process.
- Initiate re-authorizations that are set to expire 30 days prior to the term date.
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- 401k
- Accident & Critical Illness
- Life Insurance
- PTO, Holiday Pay, and Floating Holidays
- Tuition Reimbursement
Job Summary
Part Time
Skilled Nursing Services & Residential Care
$41k-50k (estimate)
05/31/2024
06/29/2024
orsinispecialtypharmacy.com
Elk Grove Village, IL
50 - 100
Skilled Nursing Services & Residential Care
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The job skills required for Prior Authorization Specialist - Remote include Prior Authorization, Patient Care, Collaboration, Integrity, Innovation, etc. Having related job skills and expertise will give you an advantage when applying to be a Prior Authorization Specialist - Remote. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Prior Authorization Specialist - Remote. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Prior Authorization Specialist - Remote positions, which can be used as a reference in future career path planning. As a Prior Authorization Specialist - Remote, it can be promoted into senior positions as an Admitting Supervisor that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Prior Authorization Specialist - Remote. You can explore the career advancement for a Prior Authorization Specialist - Remote below and select your interested title to get hiring information.
If you are interested in becoming a Prior Authorization Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Prior Authorization Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Prior Authorization Specialist job description and responsibilities
Request, follow up and secure prior-authorizations prior to services being performed.
04/09/2022: Laramie, WY
Receive requests for pre-authorizations and ensure that they are properly and closely monitored.
03/28/2022: Schenectady, NY
Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
02/27/2022: Wichita, KS
Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.
04/08/2022: Altus, OK
Reported to supervisor to assure accurate capture of services needing authorization.
02/05/2022: Dothan, AL
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Prior Authorization Specialist jobs
Prior Authorization Specialist must have excellent computer skills including Excel, Word, and Internet use.
02/12/2022: New Britain, CT
A good Prior Authorization Specialist are those who are detail oriented with above average organizational skills.
03/28/2022: Galveston, TX
Basic understanding of human anatomy, specifically musculoskeletal would also give you benefits for this role.
04/04/2022: Lebanon, PA
Some experience in medical billing or insurance authorization are strongly preferred by most employers.
03/10/2022: Jamestown, NY
Licenses and certifications are not usually required to work as a prior authorization specialist.
04/02/2022: Mcallen, TX
Step 3: View the best colleges and universities for Prior Authorization Specialist.
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