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Prior Authorization Coordinator (On-site)

Innomar Strategies

Innomar Strategies

Reading, PA, USA
Posted on Oct 27, 2023

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today!

What you will be doing

Under the direct supervision of the Pharmacist or other supervisory/management-level position in the facility, works on our prior authorization team to complete authorizations for various clinics, disease states, and medications. This position is categorized as compliance critical and, as such, requires and is assigned specific responsibility for ensuring continual and proper compliance with all division, corporate and regulatory requirements


AmerisourceBergen has managed and staffed the Reading Hospital Ambulatory Pharmacy inside of the 700 bed Reading Hospital since 2017. In 2023 a second community pharmacy will be opened to serve the Doctors Office Building located on campus.

We foster a culture where career development and training play a key role as our staff gain experience in many aspects of ambulatory and specialty pharmacy. We currently employ pharmacists in both clinical and ambulatory settings with a support staff of technicians in various roles. We are excited to welcome new team members to continue to grow our team and kickstart new careers.

We started with 2 pharmacists and 4 technicians and have since expanded into a much larger operation with services such as:

  • meds-to-beds
  • employee prescriptions
  • pharmacist navigators embedded in clinics
  • Specialty Pharmacy

This position is a prior authorization specialist position located at our client site, the Reading Hospital Ambulatory Pharmacy, 420 South 5th Avenue, West Reading, PA 19611. Full time, 8 hours per day, 40 hours per week.

PRIMARY DUTIES AND RESPONSIBILITIES:

  • Manage prior authorization work queue
  • Navigate electronic medical record to leverage relevant progress notes, telephone encounters, and patient demographics
  • Call payers and verify patient’s insurance benefits, including assessing for authorization requirements on secondary insurance, if applicable.
  • Follow up with payers to check status of previously submitted prior authorizations
  • Provide clear communication and documentation on status of prior authorization(s) to patient, multidisciplinary providers, and pharmacy.
  • Collaborate with multidisciplinary team to resolve prior authorization denials
  • Determine location of pharmacy fulfillment – either Reading Hospital Ambulatory Pharmacy, or other pharmacy contracted with insurance.
  • Communicates feedback of patients, clinic staff, and pharmacies to enhance process improvement
  • Escalate clinical questions to pharmacist as needed
  • Performs related duties as assigned

What your background should look like

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

  • Minimum of two (2) years directly related and progressively responsible pharmacy experience; bachelor's degree program preferred.
  • Pharmacy technician certification with a national technical certification organization, such as Pharmacy Technician Certification Board (PTCB) or other comparable national certification or comparable state certification.

MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:

  • Computer skills, ability to navigate electronic medical records
  • Communicate effectively both orally and in writing
  • Work quickly and accurately under time and volume constraints
  • Strong interpersonal skills
  • Resolve issues quickly and creatively in order to improve customer satisfaction
  • Familiarity with pharmaceutical products, services and drug interactions
  • Strong organizational and time management skills are essential
  • Good analytical skills

What Cencora offers

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave.

To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more.

For details, visit https://www.virtualfairhub.com/amerisourcebergen

Schedule

Full time

Affiliated Companies

Affiliated Companies: Value Apothecaries Inc

Equal Employment Opportunity

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.

The company’s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.