Prior Authorization Specialist - Remote

A Prior Authorization Specialist at Orsini Specialty Pharmacy plays a critical role in validating patient prescriptions and insurance eligibility. They communicate with physician offices, interpret medical policies, and convert prescriptions into authorization requests, ensuring patients can access vital medications and treatments.

Candidates for the Prior Authorization Specialist position at Orsini Specialty Pharmacy should have experience with major medical insurance, knowledge of pharmacy benefits, as well as familiarity with HCPC and ICD-10 codes. Prior pharmacy experience is preferred but not required.

Orsini Specialty Pharmacy provides comprehensive employee benefits for its Prior Authorization Specialists, including medical, dental, and vision insurance. Additionally, we offer 401k, life insurance, and education reimbursement programs to support their life and career goals.

At Orsini Specialty Pharmacy, the work culture is built on empathy, collaboration, and innovation. We emphasize our core LIVE IT values which guide team members in their interactions, fostering a caring environment that prioritizes excellence in patient care.

A Prior Authorization Specialist may face challenges such as navigating complex insurance policies, ensuring clinical documentation meets payer requirements, and managing multiple authorization requests simultaneously. However, a supportive team and structured workflow help you overcome these hurdles.

Prior Authorization Specialists at Orsini should have strong analytical skills to read and interpret prescriptions, attention to detail for accurate documentation, and excellent communication abilities to liaise with providers and insurance companies effectively.

Yes, the Prior Authorization Specialist role at Orsini Specialty Pharmacy is a remote position, allowing for flexibility and work-life balance while contributing to our mission of delivering compassionate healthcare solutions.

When answering this question, provide specific examples from your previous roles, focusing on your familiarity with health insurance processes and any successes you've had in obtaining prior authorizations for complex cases.

Discuss your approach to clear and concise communication, emphasizing the importance of building professional relationships and how you ensure that you gather all necessary clinical documentation promptly.

Provide an insight into pharmacy benefits' functions, such as working closely with insurance plans to coordinate patient care, and stress how this impacts the prior authorization process at Orsini Specialty Pharmacy.

Share a specific story detailing the challenge, the steps you took to resolve the issue, and the outcome, highlighting your problem-solving skills and attention to detail.

Talk about your methods for organizing tasks, such as utilizing to-do lists or project management tools, and provide an example of how you have effectively managed multiple requests under tight deadlines.

Explain how you regularly review insurance and medical policies, stay updated on changes, and utilize your knowledge during the authorization process to keep your work compliant.

Articulate your passion for the healthcare field, your alignment with Orsini's mission of No Patient Left Behind™, and how the company's values resonate with your personal ethos and professional goals.

Identify skills such as attention to detail, communication, and critical thinking as pivotal to the role, and provide examples of how you’ve demonstrated each in your past positions.

Discuss your organizational strategies, such as leveraging electronic health records, tracking pending requests, or maintaining meticulous notes to streamline the authorization process.

Share your familiarity with electronic systems used for prior authorizations, explaining how you've used these tools to expedite processes and enhance communication with stakeholders.