Prior Authorization Specialist

A closed door pharmacy is looking to hire a Prior Authorization Specialist. This role will include assisting in the initiation of new prior auth requests, identifying correct forms required for patients insurance, coordinating information for forms, and following up with medical offices. These individuals must have experience working in a previous pharmacy setting and must have a strong ability to multitask.

Responsibilities:
• Process pharmacy claims accurately and timely to meet client expectations
• Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage
• Maintain compliance with patient assistance program guidelines
• Document all information and data discovery according to operating procedures
• Research required information using available resources
• Maintain confidentiality of patient and proprietary information
• Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws
• Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

• 1+ year(s) working with prior authorizations or insurance verification in a pharmacy
• High school diploma or GED required, Bachelor’s degree strongly preferred
• Customer service or inbound call center experience required
• Sound technical skills, analytical ability, attention to detail, good judgment, and strong operational focus
• Must be flexible to work shifts ranging from 8am - 8pm.

• 1+ year(s) working with prior authorizations or insurance verification in a pharmacy
• Knowledge of pharmacy benefits and pharmacy claims

Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.