Job Description
Must have BOTH a current VA Pharmacy and PTCB License The Reimbursement Specialist improves revenue collection pertaining to high cost medications that require prior authorization. This job will initiate, follow-up, and proceed with approval and/or denials of prior authorizations efficiently via phone, fax, or electronically. The Reimbursement Specialist carries out benefit investigation and coordinates Patient Assistance Programs and/or copay cards for patients with high co-pays or those witho…
7:00 AM
Review the surgical and procedure schedule for the next 48–72 hours. Every case that requires authorization needs to be cleared be…
7:30 AM
Pull the PA worklist. Filter by date of service — cases with the earliest service dates get worked first. High-cost procedures (su…
8:30 AM
Submit PA requests to payers. Each payer has its own portal, its own forms, its own documentation requirements. You know them all…
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