Job Description
Methodist Le Bonheur Healthcare seeks a Specialty Pharmacy Prior Authorization Specialist to secure timely approvals for complex medications and medical services. In this role, you will review clinical documentation, interpret insurance and payer policies, and submit, track, and resolve authorization requests and appeals. You will work closely with physicians, pharmacy, care teams, and insurers to
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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