Pharmacy Prior Authorization Specialist

The Prior Authorization (PA) Specialist is responsible for all aspects of the prior authorization process while continuously monitoring and ensuring compliance through established procedures and documentation. Responsibilities include collecting all the necessary documentation, contacting the client for additional information to complete the PA process. Complete, timely, and accurate identification and submission of prior and retro authorization requests to payors. Interacts with clients, insurance companies, patients, as necessary, to request for prior authorizations. Responsible for documenting account activity, updating patient and claim information and demonstrates proficiencies with Epic, CoverMyMeds, and other billing platforms to ensure all functionalities are utilized for the most efficient processing of claims and identifies PA trends and/or issues resulting in delayed claims processing. Provides the highest level of customer service to internal care teams and patients and families.

Required Education/Experience:

• High school graduate or G.E.D.
• Graduation from accredited pharmacy technician training program, or equivalent training.
• Minimum of three (3) years of retail or outpatient pharmacy practice experience.

Required Credentials:

• Licensed by the Washington State Pharmacy Department of Health as a pharmacy technician.

Preferred:

• One (1) year Seattle Children's Outpatient Pharmacy experience.
• Specialty Pharmacy and/or Centralized Prior Authorization Services knowledge. Compensation Range $32.07
• $48.

11 per hour Salary Information This compensation range was calculated based on full-time employment (2080 hours worked per calendar year). Offers are determined by multiple factors including equity, skills, experience, and expertise, and may vary within the range provided. Seattle Children's offers annual incentive pay based upon performance that is commensurate with the level of the position. Disclaimer for Out of State Applicants This compensation range is specific to Seattle, positions located outside of Seattle may be compensated differently depending on various factors . Benefits Information Seattle Children's offers a generous benefit package, including medical, dental, and vision plans, 403(b), life insurance, paid time off, tuition reimbursement, and more. Click here for more information.