Job Description

Join to apply for the Prior Authorization role at Polaris Pharmacy Services Continue with Google Continue with Google 4 days ago Be among the first 25 applicants Join to apply for the Prior Authorization role at Polaris Pharmacy Services Get AI-powered advice on this job and more exclusive features. Continue with Google Continue with Google Continue with Google Continue with Google Continue with Google Continue with Google Continue with Google Continue with Google Continue with Google Continue with Google Continue with Google Continue with Google Who We Are Polaris Pharmacy Services is an industry leader in both the Long-Term Care and Post-Acute Care settings. Founded in 2015, we are locally and independently owned with pharmacies. We are proud to offer competitive benefits and industry pay as well as the opportunity for career advancement to all our team members. Currently we are recruiting for experienced Prior Authorization Technicians to join the Polaris team.

PRIOR AUTHORIZATION SPECIALIST

Who We Are Polaris Pharmacy Services is an industry leader in both the Long-Term Care and Post-Acute Care settings. Founded in 2015, we are locally and independently owned with pharmacies. We are proud to offer competitive benefits and industry pay as well as the opportunity for career advancement to all our team members. Currently we are recruiting for experienced Prior Authorization Technicians to join the Polaris team. Overview The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior Authorization Specialist must be responsive and courteous when addressing our customers needs. Successful Specialists are dedicated to meeting the expectations and requirements of the position; understanding customer information and using it to improve products and services we deliver; talking and acting with customers in mind; establishing and maintaining effective relationships with co-workers and customers, thus gaining our customers trust and respect. Responsibilities Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers Research, analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines Ensure approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement Contact providers and/or customers as necessary to obtain additional information Monitor and resolve revenue at risk associated with payer set up, billing, rebilling, and reversal processes Work as a team to identify, document, communicate, and resolve payer/billing trends and issues Complete, communicate, and submit necessary payer paperwork, including but not limited to prior authorizations forms and manual billing in a timely manner Review and work convert billing exception reports to ensure claims are billed to accurate financial plans Complete billing transactions for non-standard order entry situations as required Support training needs Prepare and maintain reports and records for processing Perform other tasks as assigned. Follow all applicable government regulations, including HIPAA Comply with departmental policies regarding safety, attendance, and dress code Overtime, holidays, and weekends may be required and/or expected Conduct job responsibilities in accordance with the standards set out in the Companys Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards Other duties as assigned; Job duties may vary depending on business needs Qualifications High School diploma or equivalent required Minimum of one (1) or more years working as a pharmacy technician in a retail environment required (long-term care pharmacy preferred) Framework LTC & General computer knowledge & 10-key Number Entry preferred Able to read, write, speak, and understand the English language Able to retain a large amount of information and apply that knowledge to related situations Able to work in a fast-paced environment Basic computer knowledge skills required Basic math and analytical skills Experience with alpha-numeric data entry Proficient in Microsoft Word, Excel, and Outlook required Customer Service Results-oriented Good organization/Attention to detail Reliable Problem solver Able to work various shifts and days Adaptability to an ever-changing environment

PHYSICAL DEMANDS

The Physical Demands Described Here Are Representative Of Those That Should Be Met By An Employee To Successfully Perform The Essential Functions Of This Job May sit or stand seven (7) to ten (10) hours per day The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, crouch, walk, crawl intermittently May be necessary to work extended hours as needed May lift and/or move up to 50 pounds The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role

HOLIDAY & PTO POLICY

Paid holidays are provided annually, with 6 days offered each year, along with 5 sick days. Employees earn up to 10 PTO days each year, with rollover options and milestone bonuses. Employees have the option to cash out up to 10 PTO hours each quarter for added financial flexibility. Please note we are a long-term care pharmacy open 24-hours a day, 7 days a week. And schedules may change as determined by the needs of the business. BENEFITS For Full Time Employees Medical, Dental, and Vision insurance 401 (k) (available for Part Time & Full Time EEs) Company Paid Life insurance Short-term and Long-term disability insurance Tuition reimbursement Personal Time Off (PTO) Competitive pay with annual performance reviews and merit-based raises Career growth potential Annual on-site voluntary Flu Vaccine Employee referral bonus program Seniority level Seniority level Mid-Senior level Employment type Employment type Full-time Job function Job function Other Industries Pharmaceutical Manufacturing Referrals increase your chances of interviewing at Polaris Pharmacy Services by 2x Sign in to set job alerts for “Prior Authorization” roles. Continue with Google Continue with Google Continue with Google Continue with Google UM Prior Authorization Nurse, LVN/LPN (Work from Home) UM Prior Authorization Nurse, LVN/LPN (Work from Home) Rancho Mirage, CA $18.00 - $20.00 9 hours ago Pharmacy Program Coordinator - Clinical Prior Authorization - Remote City of Industry, CA $17.00 - $28.35 22 hours ago Intake Coordinator - Full-Time - Saturday to Wednesday Los Angeles, CA $47,840.00 - $68,474.00 20 hours ago Santa Clarita, CA $38,272 - $65,104 6 days ago Santa Clarita, CA $63,000 - $73,000 2 days ago Intake/Referral Coordinator On Site Santa Fe Springs Santa Fe Springs, CA $21 - $31.99 1 month ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr Polaris Pharmacy Services

Job Tags

Full time, Temporary work, Part time, Remote work, Work from home, Shift work, Weekend work,

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