Job Description
Pharmacy Authorization Specialist
Ridge, NY
Hours: Monday through Friday 8:30 to 5:00
Why Join Us?
At
New York Cancer & Blood Specialists (NYCBS) , we create an environment where dedicated professionals can thrive. Our team of expert oncologists, hematologists, and compassionate staff work across numerous locations with one shared mission: conquering cancer close to home. Through cutting-edge treatments, innovative research, and a patient-centered philosophy, we are redefining what’s possible in the fight against cancer and blood disorders. Join our growing organization and help us bring healing, hope, and advanced care to the communities we proudly serve.
In this role, you will:
- Run and work daily Business Office Report in OncoEMR for drug order values: POD Verify and
- NYCBS Pharm Fill for current date of service and one week out to be worked to obtain prior
- authorizations. All STAT orders are to be worked immediately upon request by onsite team.
- Work daily requests from onsite pharmacy dispensaries to obtain prior authorization on
- requested medication.
- Document notes in the Sig Box of OncoEMR in the patient’s treatment plan including approval
- status or in text note where applicable. Must document all steps taken in research/process of the
- case
- Prepare appeals for denials on prior authorization requests where applicable.
- Refer prescription fill requests that are denied or that have a patient financial responsibility to the
- pharmacy financial counselor for review.
- Ensure that all aspects of approval have been checked regarding prior authorization, pre-
- determination, and pre-certification before approving the order as meeting NYCBS policy.
- Verify patient’s own drug with pharmacy related queries where applicable.
- Notify Nursing Management if orders need to be changed to BB (patient’s own drug) or to
- Buy/Bill (billing through medical insurance)
- Work any prior authorization requests from local pharmacies on patient’s oral medications or on
- specialty pharmacy drugs.
- Maintain and ensure the confidentiality of all patient and employee information at all times.
- A pharmacy authorization specialist will be expected to work when given sufficient notice of
- Required overtime.
We require:
- High school or GED required.
- Experience in pharmacy / authorization field.
- Experience working in the healthcare field, preferably in a clinical setting or business office.
- Experience in insurance requirements and medical terminology ICD-10 and CPT coding.
- Experience in billing practice management systems, electronic medical record systems, Microsoft
- Word, and Microsoft Excel.
- Excellent verbal and communication skills between co-workers, physicians, management staff,
- patients, insurances, outside programs.
- Ability to multitask, problem solve, utilize basic math skills and follow complex instructions.
- Must have ability to converse in a calm and friendly manner.
- Able to relate and comfort patients during a difficult time.
What we offer:
Salary: Starting at $26 based on experience.
Benefits: Health Insurance on day 1, Dental, Vision, Life Insurance, Short- and Long-term disability, 401k Plan, generous PTO, 8 paid holidays (2 floating), and more.
Join us at NYCBS, where we are making strides in healthcare through innovative and compassionate care.
Visit our website at: Nycancer.com
Follow us on Facebook: NYCBS on Facebook
*New York Cancer and Blood Specialists is an Equal Opportunity Employer.*
Job Tags
Holiday work, Full time, Temporary work, Local area, Immediate start, Monday to Friday,