Pharmacy Authorization Reps
Pharmacy Authorization Reps are responsible for processing precertification or prior authorization requests for prescription drugs and medications. This job entails a wide variety of tasks including collecting and analyzing all of the pertinent data regarding prior authorization requests to insurance agencies for coverage of certain medicines.
What do They do?
As a Pharmacy Authorization Rep, a knowledge of the health insurance industry, as well as the medical and pharmaceutical fields, is necessary. Research is a required part of this particular job. This research can include anything from an in-depth analysis of a particular prescription drug, to medical insurance plans and benefits, or even resolving and exploring formulary issues and factors, always using appropriate resources and references to come to those conclusions.
Other duties required of Pharmacy Authorization Reps include taking authorization calls and faxes, processing requests, and communicating with insurance companies, pharmacists, and patients regarding authorization requests. Another important part of the job is being able to use reports to resolve accounts and disputes, and obtaining, entering, and processing patient information for accurate record-keeping. Pharmacy Authorization Reps are also known to contact physicians regarding clinical issues, and work with billing departments to resolve accounts.
To become a Pharmacy Authorization Rep, you’ll need customer service skills as well as technical expertise regarding finance, medical billing, and coding, and insurance. Experience in these industries is preferable with a minimum of 2 years in a service industry recommended. You’ll need to have a minimum of a high school diploma or GED, but often require a bachelor’s degree as well, preferably in a health-related field. Attention to detail and ability to multitask are a must with this job as are strong interpersonal skills.
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If this job sounds like it could be a good fit for you, or you’d like to check out other jobs like this one, contact HealthCare Support. Our professionals a ready to help you find employment in the health care industry that fits your strengths and schedule. Our unique employment solutions are sure to help you find your way in the ever-changing industry of health care. To learn more about us, or check out the jobs we offer, call us today at 407-478-0332.