Pre-Authorization Specialist (Pharm-D)

Obtain prior authorizations for diagnostic procedures, surgeries, medications, and other medical services.

Verify insurance coverage and authorization requirements based on patient plans.

Accurately enter authorization information into the electronic medical record (EMR) or billing system.

Communicate with insurance companies via phone, fax, and web portals.

Work closely with physicians, nursing staff, and billing teams to ensure timely service scheduling.

Track pending authorizations and follow up regularly to ensure approvals are received.

Manage denials and re-submissions when necessary.

Maintain compliance with HIPAA and internal confidentiality standards.