Authorization Representative I - BioPlus Specialty Pharmacy

Authorization Representative I - BioPlus Specialty Pharmacy

Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

BioPlus Specialty Pharmacy is a proud member of the Elevance Health family of companies. BioPlus offer consumers and providers an unparalleled level of service that's easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer's treatment journey.

The Authorization Representative I will be responsible for the completion and submission of appropriate forms for patients whose health plan requires drug re-authorizations for different therapy types.

How you will make an impact:

• Enters re-authorizations into the portal and ensures accurate completion of re-authorization forms.
• Submits completed re-authorization forms to the appropriate insurance plans.
• Maintains log of all re-authorizations submitted.
• Follows up with the patient's insurance company or physician office by phone, email or spreadsheets on all submitted re-authorization for patient approval/denial status.

Minimum Requirements:

• Requires a HS diploma or GED and a minimum of 1 year of experience processing pharmacy prior authorizations; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Certified Pharmacy Technician highly desired.
• Specialty pharmacy experience highly preferred.
• Medical terminology training is preferred.
• Experience with Prior Authorizations, Denials and Appeals highly desired.