PharMerica
OverviewJoin our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!
Schedule: Mon-Fri(8:30am to 5pm)
This is a hybrid opportunity. Applicants must reside in, or commutable distance, to Louisville, KY
We offer:
DailyPay
Flexible schedules
Competitive pay
Shift differential
Health, dental, vision and life insurance benefits
Company paid STD and LTD
Tuition Assistance
Employee Discount Program
401k
Paid-time off
Tuition reimbursement
Non-retail/Closed-door environment
Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!
*Position will be posted for a minimum of 7 business days
ResponsibilitiesThe Pharmacy Lead Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or coordinating with prescribers and/or facility contacts to have therapy changed to a preferred alternative due to insurance not covering the treatment in question. The Pharmacy Lead PA Coordinator also oversees new hire training completed by the Prior Authorization Coordinator II.
Helps manage staff appropriately and sets clear expectations for performanceWorks with Billing Coordinator/Supervisor/Manager in researching pharmacy accounts requiring special attentionAssists Billing Coordinator/Supervisor/Manager in overseeing daily prior authorization activities per policies and procedures when necessaryEnsures appropriate, timely and professional communications occurs with Implementation team, Account Management team, Directors of Pharmacy, and Facility staff as neededAudits prior authorization functions regularly for compliance to policies, procedures, contract and government regulationsPrioritizes and delegates job tasks to ensure timely completionFollows all applicable government regulations including HIPAAParticipates in projects and/or management meetingsAddresses workflow and/or business issues while keeping direct manager informedParticipates on various prior authorization specific sub-groups to identify all attributes for best practice implementation and influences development of policies and procedures as well as identifies appropriate training material and educational opportunitiesImplements proper prior authorization forms and forwards them to physicians to obtain approvalCompletes change of therapy forms to facility contacts and physiciansAdjudicates claims, researching formularies for numerous insurance plans, contacting physician’s office, updating spreadsheets on a daily basis, follow-up and obtain approval or denial of prior authorizationsCommunicates timely and in a courteous manner to the physician/clinical staff regarding authorization status or delaysOversees and approves updates made to the Prior Authorization Training Manuals by the Pharmacy Prior Authorization Coordinator II Qualifications High School Diploma/GED requiredPharmacy Tech License preferredExcellent customer service and communication skills, both written and verbalAbility to prioritize and meet pre-determined deadlinesMust be able to effectively multi-task, be proficient at typing, and have advanced technical skillsExperience in healthcare billing environment (pharmacy preferred)Familiarization with online claims processing and Medicaid and Medicare billing practicesProficient with Microsoft Word & Excel requiredIf a current PAL employee, you must:Have 6+ months of prior authorization experience as PAL Core Prior Authorization CoordinatorAdhere to Pharmacy Alternatives, LLC attendance policyExcel and adhere to core Pharmacy Alternative Prior Authorization responsibilitiesNot be on any form of Performance Improvement/Corrective Action Plan About our Line of Business PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.