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Southern Home Care Services, Inc. PRIOR AUTHORIZATION COORDINATOR in Louisville, Kentucky

Requisition: 2024-148705

PRIOR AUTHORIZATION COORDINATOR
Job LocationsUS-KY-LOUISVILLE
ID2024-148705Line of BusinessPharmacy AlternativesPosition TypeFull-TimePay MinUSD $15.25/Hr.Pay MaxUSD $15.25/Hr.
Our Company

Pharmacy Alternatives

Overview

Join our Pharmacy Alternative team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!

CPhT preferred.

Schedule: Monday-Friday from 8am - 5pm Central Time. This role is based out of Louisville, KY and after training, will become a hybrid schedule with time spent in the office as well as your home office.

Applicants must live in or a commutable distnce to Louisville.

We offer:

DailyPay

Flexible schedules

Competitive pay

Shift differential

Health, dental, vision and life insurance benefits

Company paid STD and LTD

Tuition Assistance

Employee Discount Program

401k

Paid-time off

Tuition reimbursement

Non-retail/Closed-door environment

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 is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with prescribers and or facility contact to have therapy changed to a preferred alternative due to insurance not covering the treatment in question

Essential Job Responsibilities:

  • Ensure 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 four to five business days
  • Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of Pharmacy on weekly basis
  • Compares system report of unbilled claims requiring prior approval to QuickBase 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 resolution of claim rejections as needed
  • Utilizes Frameworks, QuickBase, Docutrack, and CoverMyMeds in order to complete workflow on daily basis
  • Other responsibilities as assigned
Qualifications
  • High School Diploma/General Education Diploma required
  • Kentucky Pharmacy Technician 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 on-line claims processing and Medicaid and Medicare billing practices
  • Proficient with Microsoft Word & Excel required
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 isone of the nation'slargest 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 onFacebookandLinkedIn.
Salary Range
USD $15.25 / Hour

Res-Care, Inc., dba BrightSpring Health Services (“ResCare”), is an Equal Opportunity Employer. ResCare does not discriminate against any person on the basis of gender, r ace, color, national origin, r eligion, disability, age, veteran status, gender identity or s exual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.

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