PharmScript is one of the nations leading pharmacies, partnering with long-term and post- acute care facilities to supply medications to thousands of residents and patients. When you join the PharmScript family, you join the ranks of more than 2,000 dedicated people across the country who help to get safe, accurate, and timely medication to those who need it most.

Were looking for a RCO-Prior Authorization Claims Specialist to join our PharmScript team within our Revenue Cycle Operations department. The Prior Authorization Claims Specialist reports to the Prior Authorization Claims Supervisor within the Revenue Cycle Operations department.Theidealcandidateisapeoplepersonwhoenjoystroubleshootingandresolvingproblems and is dedicated to helping customers. For you, no task feels too small and no challenge impossible. Excellent communication and interpersonal skills are essential.

• Responsible for the daily workflow of rejected prior authorization and non-formulary claims within compliant guidelines
• Communicate directly with the Lead Prior Authorization Claims Specialist with all identified challenges, successes, and concerns from all internal and external customers
• Communicate with other team members throughout RCO, operations, customer success and cost containment to deliver additional value to contracted long term care facilities
• Work special projects as needed
• Research and respond to customer billing issues/reports in timely manner
• Maintain professional internal and external relationships that reflect the values of PharmScript

• High school diploma
• Experience with prior authorization/interchange adjudication
• Able to work independently as well as in a diverse, team environment
• Experience in long term care preferred
• Technician certification

The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:

• May sit or stand seven (7) to ten (10) hours per day
• The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, crouch, walk, crawl intermittently
• May be necessary to work extended hours as needed
• May lift and/or move up to 25 pounds
• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role

• Able to identify and resolve issues quickly and efficiently
• Excellent communication and organizational skills
• Able to work under pressure and meet deadlines
• Must be able to work in a fast-paced environment
• Strong analytical, problem solving and strategic thinking skills
• Ability to manage and develop diverse teams
• Strong leadership and customer service skills
• Moderate to advanced computer skills required
• Proficient in Microsoft Office

PharmScript offers a robust suite of benefits to support employees and their families.

Health and Wellness Benefits

• Medical, Prescription Drug, Dental, and Vision coverage for you and your eligible dependents
• Maternity care program and infertility services
• Tax-favored Health Savings Accounts, Healthcare, and Dependent Care Flexible Spending Accounts.
• EAP Assistance Program with 24/7 access to free counseling, legal guidance, and financial resources

Paid Time Off and Holidays

• 15 PTO days annually and 6 paid/floating holidays

Retirement Planning

• 401(k) retirement planning with company match

Commuter Benefits

• Transit/Parking Spending Account

Voluntary Benefits

• Employee Life and Accidental Death & Dismemberment, Short/Long-term Disability, Critical Illness, Accident, and Hospital Indemnity plans are available for you and eligible dependents,

Other Perks and Benefits

• Legal & Identity Theft Protection Programs
• Employee Discounts: Instant savings on hundreds of products and services
• Pet Insurance
• Employee Support Program to eligible employees in times of urgent need

To reinforce our commitment to fair and equal pay transparency, PharmScripts compensation is based on multiple non-discriminatory, individualized factors including but not limited to experience, job-related knowledge, education, skills, and office/market location.

PharmScript is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation and gender identity or any other status protected by federal, state, or local law.

EO/Minorities/Females/Disabled/Veterans