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RCO - Prior Authorization Claims Specialist
RCO - Prior Authorization Claims Specialist-March 2024
Lebanon
Mar 31, 2026
About RCO - Prior Authorization Claims Specialist

  Job DescriptionOverview

  PharmScriptis one of the nations leading pharmacies, partnering with long-term and post- acute care facilities to supply medications to thousands of residents and patients. When you join the PharmScript family, you join the ranks of more than 2,000 dedicated people across the country who help to get safe, accurate, and timely medication to those who need it most.Were looking for a RCO-Prior Authorization Claims Specialist to join our PharmScript team within our Revenue Cycle Operations department. The Prior Authorization Claims Specialist reports to the Prior Authorization Claims Supervisor within the Revenue Cycle Operations department.Theidealcandidateisapeoplepersonwhoenjoystroubleshootingandresolvingproblems and is dedicated to helping customers. For you, no task feels too small and no challenge impossible. Excellent communication and interpersonal skills areessential.

  Responsibilities

  Key Responsibilities:

  Responsible for the daily workflow of rejected prior authorization and non-formulary claims within compliant guidelinesCommunicate directly with the Lead Prior Authorization Claims Specialist with all identified challenges, successes, and concerns from all internal and external customersCommunicate with other team members throughout RCO, operations, customer success and cost containment to deliver additional value to contracted long term care facilitiesWork special projects as neededResearch and respond to customer billing issues/reports in timely mannerMaintain professional internal and external relationships that reflect the values of PharmScriptQualifications

  Qualifications:

  High school diplomaExperience with prior authorization/interchange adjudicationAble to work independently as well as in a diverse, team environmentExperience in long term care preferredTechnician certificationSkills and Abilities:

  Able to identify and resolve issues quickly and efficientlyExcellent communication and organizational skillsAble to work under pressure and meet deadlinesMust be able to work in a fast-paced environmentStrong analytical, problem solving and strategic thinking skillsAbility to manage and develop diverse teamsStrong leadership and customer service skillsModerate to advanced computer skills requiredProficient in Microsoft OfficeEEO Statement:PharmScript is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation and gender identity or any other status protected by federal, state or local law.EO/Minorities/Females/Disabled/Veterans

  Min

  USD $18.00/Hr.Max

  USD $19.00/Hr.

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