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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in processing pharmacy prior authorizations and managing patient interactions with insurance companies. Proficient in maintaining accurate records and ensuring compliance with medical terminology and specialty pharmacy practices.
Highest-signal resume keywords
Pharmacy Prior AuthorizationsCertified Pharmacy TechnicianSpecialty Pharmacy ExperienceMedical Terminology TrainingExperience With Denials And Appeals
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Re-Authorization ProcessingForm CompletionPatient Approval TrackingInsurance SubmissionLog Maintenance
Soft Skills
CommunicationFollow-UpAttention To Detail
Tools & Technologies
Portal SystemsSpreadsheets
Certifications & Qualifications
Certified Pharmacy Technician
Industry Keywords
Specialty MedicationsWhole-Health ServicesMedical Insurance
About the role
Key responsibilities & impact- Enter re-authorizations into the portal
- Ensure accurate completion of re-authorization forms
- Submit completed re-authorization forms to appropriate insurance plans
- Maintain a log of all re-authorizations submitted
- Follow up with patients' insurance companies or physician offices by phone, email, or spreadsheets
- Track patient approval/denial status
- Complete and submit appropriate forms for patients whose health plans require drug re-authorizations
- Support BioPlus Specialty Pharmacy's delivery of specialty medications, personalized support, and whole-health services
Requirements
What you’ll need- HS diploma or GED
- Minimum of 1 year of experience processing pharmacy prior authorizations
- Any combination of education and experience which would provide an equivalent background
- Ability to work in-office 1–2 days per week
- Must reside within a reasonable commuting distance from one of the posting locations unless an accommodation is granted as required by law
- Certified Pharmacy Technician highly desired
- Specialty pharmacy experience highly preferred
- Medical terminology training preferred
- Experience with Prior Authorizations, Denials and Appeals highly desired
- Ability to work 1st Shift (United States of America)
- Certain patient/member-facing roles require vaccination against COVID-19 and Influenza, unless an acceptable explanation is provided
Benefits
Comp & perks- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Hybrid/virtual work flexibility
- Work-life balance support
- Personal and professional growth opportunities