Pharmacy Prior Authorization Representative

At Elevance Health, we are looking for an experienced Pharmacy Prior Authorization Representative to join our team. In this role, you will be responsible for ensuring that medications prescribed for our members are approved and in compliance with the applicable health plan's policies. You will be a key member of our Pharmacy team, providing first-class customer service to all of our members and providers. The ideal candidate should have a minimum of two years of experience in a pharmacy/medical setting, with prior authorization experience preferred. You must also have excellent customer service and communication skills, a strong attention to detail, and the ability to work in a fast-paced environment. If you are looking to join a team that is committed to providing the highest quality of care, we invite you to apply.

Responsibilities:

1. Review and process pharmacy prior authorization requests in accordance with the applicable health plan’s policies.
2. Manage customer service inquiries from members and providers related to prior authorization.
3. Research and respond to member and provider inquiries in a timely manner.
4. Monitor prescription orders for accuracy and compliance.
5. Maintain accurate documentation of prior authorization requests.
6. Collaborate with other departments to ensure the timely and accurate processing of prior authorization requests.
7. Resolve any prior authorization issues with members and providers.
8. Assist with developing and implementing new procedures for prior authorization requests.
9. Monitor and analyze trends in prior authorization requests. 10.Provide training to new Pharmacy Prior Authorization Representatives.

According to JobzMall, the average salary range for a Pharmacy Prior Authorization Representative in St. Louis, MO, USA is between $35,000 and $43,000 per year. The median salary for this position in St. Louis is $39,000.

Elevance Health, Inc. is an American health insurance provider. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Empire BlueCross BlueShield in New York State, Anthem Blue Cross in California,Wellpoint, and Carelon.It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within their affiliated companies' health plans. Prior to June 2022, Elevance Health was named Anthem, Inc.