Specialist I, Prior Authorization-Remote
Madison, WI 
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Posted 11 days ago
Job Description

Lumicera Health Services Powered by Navitus

Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.

We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

Under direction from the Supervisor, Specialty Pharmacy Services, and pharmacists in the Specialty Pharmacy, the Prior Authorization Specialist I is primarily responsible for obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy. The Prior Authorization Specialist's main objective is to answer phone calls and contact the doctors and patients via fax or phone or other communication means to facilitate and document prior authorization approval. The Prior Authorization Specialist may also be responsible for ensuring that all pertinent patient information is contained within the record. Patient information shall include demographics, allergies, medication history, comorbidities, and payer information. This position will function with and assist any other area in the facility as needed with regard to prior authorization type duties.

Is this you? Find out more below!

How do I make an impact on my team?

  • Responsible for answering the inbound calls from patients, prescribers, and other healthcare professionals.
  • Responsible for contacting doctors to obtain necessary information.
  • Responsible for managing the assigned workflow queues.
  • Responsible for accurate and thorough documentation of information and prescription order set up.
  • The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee.
  • May be asked to perform other duties as requested by Supervisor or pharmacist.

What our team expects from you?

  • High school diploma or GED. Some college preferred.
  • CPhT Preferred
  • Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure.
  • Minimum two years pharmacy support experience or healthcare environment experience preferred.
  • Participate in, adhere to, and support compliance program objectives
  • The ability to consistently interact cooperatively and respectfully with other employees

What can you expect from Lumicera?

  • Hours/Location: Monday - Friday, 8 hour shifts vary between the hours of 8am-7pm, CST-Remote
  • Paid Volunteer Hours
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program - up to $750!
  • Top of the industry benefits for Health, Dental, and Vision insurance, Flexible Spending Account, Paid Time Off, Nine paid holidays, 401K, Short-term and Long-term disability, College Savings Plan, Paid Parental Leave, Adoption Assistance Program, and Employee Assistance Program

#LI-Remote


Navitus Health Solutions is an Equal Opportunity Employer: Disabled/Veterans/Male/Female/Minority/Other


 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Salary and Benefits
18.13 To 22.60 (USD) Annually
Required Experience
2+ years
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