Louisville, Kentucky

Our Company

Overview

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.

Responsibilities

  • The Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with prescribers and or facility contact to have therapy changed to a preferred alternative due to insurance not covering the treatment in question

Essential Job Responsibilities:

  • Ensure accurate and timely completion of client prior authorization and/or change of therapy paperwork by collaborating with prescribers and facility contacts
  • Follows up on all claims requiring prior authorization within four to five business days
  • Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of Pharmacy on weekly basis
  • Compares system report of unbilled claims requiring prior approval to QuickBase tracking system to ensure any claim requiring prior authorization is being followed up on
  • Assists Billing Department with resolving unbilled claims at each month end close
  • Advocates for clients as needed
  • Support for Pharmacy Operations
  • Adjudicates and resolution of claim rejections as needed
  • Utilizes Frameworks, QuickBase, Docutrack, and CoverMyMeds in order to complete workflow on daily basis
  • Other responsibilities as assigned

Qualifications

  • High School Diploma/General Education Diploma required
  • Kentucky Pharmacy Technician License preferred
  • Excellent customer service and communication skills, both written and verbal
  • Ability to prioritize and meet pre-determined deadlines
  • Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
  • Experience in healthcare billing environment (pharmacy preferred)
  • Familiarization with on-line claims processing and Medicaid and Medicare billing practices
  •  Proficient with Microsoft Word & Excel required

About our Line of Business

Pharmacy Alternatives®, a PharMerica company, is a specialized pharmacy provider focused on serving individuals with cognitive, intellectual and developmental disabilities (I/DD) helping people live their best life.  Pharmacy Alternatives combined with PharMerica offer unmatched long-term pharmacy solutions specializing in serving special-needs populations who live in intermediate care facilities, waiver homes, group homes, assisted living, supported-living or foster care.  PharMerica is one of the nation's largest pharmacy companies.  The combined organization offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades. For more information about Pharmacy Alternatives, please visit www.palrx.com. Follow us on Facebook and LinkedIn.

Louisville, Kentucky

BrightSpring is the parent company of a family of services and brands that provides clinical, nonclinical, pharmacy and ancillary care services for people of all ages, health and skill levels across home and community settings.

The company is the leading provider of diversified home and community-based health and pharmacy services to medically complex and high-need populations. Its primary businesses include: behavioral health (including autism services), home health care (including personal care, home health, and hospice), neuro therapy, and job placement and vocational training, supported by pharmacy and telecare ancillary technologies and services. These businesses employ over 50,000 dedicated team members in 50 states and provide services for over 350,000 people every day.

BrightSpring. Not just your best career. Your best life.

At BrightSpring, we need excellent people. To do excellent things. Have you wanted to make a difference in the lives of people – or entire communities? At BrightSpring you can.

This in fact could be the amazing opportunity you have been looking for. Have you wanted to find a place where there was no limit to the training you can receive throughout your career? BrightSpring® has it all. Why not find out what we can offer you?

BrightSpring lets you choose the health care field that fits you best.

·        HomeCare Services

·        Community Living Services

·        Family & Youth Services

·        Neuro Rehabilitation Services

·        Behavioral Health Services

·        Telecare & Remote Support

·        Pharmacy Services

·        Workforce Services

 

At BrightSpring, we’re putting out the call for everyone from caregivers to nurses to specialists to administrators to business leaders and IT innovators. If you want to be a part of an organization that is shaping the future of American health care, we invite you to take a look at what BrightSpring can offer you…

 

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