At Amber Specialty Pharmacy, our commitment to patient care is unmatched. This role offers the opportunity to positively impact patients with complex and chronic conditions.
Work schedule is Monday to Friday, 8 a.m. to 5 p.m. CST, no weekends.
The Dedicated Authorization Management Specialist is responsible for preparing prior authorizations and appeals, communicating with prescribers, and documenting information in the electronic medical record for assigned product programs. The role involves gathering patient history, completing appeals and prior authorizations accurately and timely, and providing exceptional customer service.
Primary duties include initiating and completing prior authorizations and appeals for specialty pharmacy patients, working directly with providers, health plans, PBMs, and specialty pharmacies, obtaining status updates, submitting requests electronically, and maintaining accurate documentation.
The position requires collaboration with program team members and advocacy on the patient's behalf to identify coverage issues. Assisting licensed professionals in reviewing patient records and payer requirements is also part of the role.
Professional competencies include proficiency with MS Excel, Word, and Outlook, understanding insurance verification and prescription adjudication, strong communication skills, self-initiative, and meeting tight deadlines. Knowledge of Medicare, Medicaid, Commercial Insurance, grant programs, prior authorizations, and claim rejections is needed.
A high school diploma or equivalent and knowledge of the healthcare industry are required. HIPAA training and ability to protect confidential information are necessary. Six months or less of related experience preferred. Nationally Certified Pharmacy Technicians are preferred.
Working conditions consist of a normal office environment with typical office equipment. Physical requirements include remaining stationary up to 90% of the time and occasional movement within the office.
Candidates must pass a pre-employment drug test, background check, and health screening if applicable.
Join Amber Specialty Pharmacy's mission to provide exceptional patient care!
- High school diploma or equivalent
- Six months or less of similar or related work experience
- Working knowledge of healthcare industry and insurance programs including Medicare, Medicaid, and commercial insurance
- HIPAA trained or ability to handle confidential patient information
- Proficiency with MS Excel, Word, Outlook
- Strong oral, written, and interpersonal communication skills
- Knowledge or experience with pharmacy prior authorizations, appeals, and copay cards preferred
- Ability to read and understand handwritten patient medical records
- Nationally Certified Pharmacy Technician preferred
- Ability to meet tight deadlines and self-initiate work
- Must pass pre-employment drug test and background check
- Monday to Friday schedule, no weekends
- Six paid holidays
- Opportunity to work in a patient-impact focused environment
- Regular office hours from 8 a.m. to 5 p.m. CST
Location
Omaha, Nebraska, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 week ago