Pharmacy Authorization Specialist (Pharmacy Technician)
UHS
Summary
The Pharmacy Authorization Specialist (Pharmacy Technician) serves as the coordinator between Prominence Health Plan, its members and contracted providers for the prior authorization review process.
Job description
The main focus of this position is preparing and loading prior authorizations for injectable drugs. This includes ensuring proper diagnosis and billing codes are input and verifying the accuracy of the dose and frequency of submitted requests.
In addition, this individual will perform provider outreach to obtain sufficient documentation for coverage determinations as necessary.
We are looking for someone with an understanding of medical drug billing and a background that includes interpreting clinic notes and/or drug orders.
By performing these duties, the Pharmacy Authorization Specialist will coordinate an effective and efficient review process, improving the internal workflow of the pharmacy team and increasing member and provider satisfaction with our prior authorization review process.
Requirements
- High School diploma or equivalent
- Current and valid state licensure as a pharmacy technician is required
- 3+ years in hospital or retail pharmacy is preferred
- Ability to effectively communicate in English, both verbally and in writing
- Knowledge of medical terminology
- Exceptional customer service skills, interfacing between the health plan and providers’ offices
- Understanding of the medical drug billing process
- Proficient in Microsoft Office
- Enjoys working in both individual and team settings
- Comfortable calculating doses and frequencies for medication treatment regimens
- Self-starter, resourceful and able to execute projects in a fluid and fast paced environment
- Strong analytical skills
- Knowledge of the purpose and process of prior authorizations
- Attention to detail and accuracy
- Ability to utilize technology and work within multiple software programs
- Understanding of health plan departments and functional areas for problem resolution
- Comfortable collecting and tracking performance metrics and reports
Benefits
- Loan Forgiveness Program
- Competitive Compensation
- Paid Time Off
- Medical, Dental & Vision
- Prescription Drug Plans
- 401(k) Matching
- Discounted Stock Plan
- Student Loan Refinancing
- Career Development
Company overview
Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected providers of hospital and healthcare services, operating as a Fortune 300 corporation headquartered in King of Prussia, Pennsylvania. Founded in 1979, UHS has grown into a major healthcare enterprise with approximately 99,000 employees and annual revenues exceeding $14 billion. The company operates through its subsidiaries, managing 29 acute care hospitals, 331 behavioral health facilities, and 60 outpatient and other facilities across 39 U.S. states, Washington D.C., Puerto Rico, and the United Kingdom. UHS provides comprehensive healthcare services including acute care, behavioral health treatment, cancer centers, and ambulatory surgical centers. The company's strategy focuses on building or acquiring high-quality hospitals in rapidly growing markets and investing in advanced medical equipment and skilled personnel to become the leading healthcare provider in each community it serves. UHS is publicly traded on the New York Stock Exchange (NYSE: UHS) and has established a strong reputation for delivering compassionate, high-quality care while maintaining financial stability and operational excellence.