Prior Authorization Coordinator

About AmeriPharma

AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.

AmeriPharma’s Benefits

• Full benefits package including medical, dental, vision, life that fits your lifestyle and goals


• Great pay and general compensation structures


• Employee assistance program to assist with mental health, legal questions, financial counseling etc.


• Comprehensive PTO and sick leave options


• 401k program


• Plenty of opportunities for growth and advancement


• Company sponsored outings and team-building events


• Casual Fridays

Job Description:

We are seeking a highly organized and detail-oriented Prior Authorization Coordinator to join our dynamic team. The ideal candidate will be responsible for obtaining prior authorizations for medical and prescription services, managing appeals, and ensuring that all necessary documentation is submitted to insurance companies in a timely manner. This role is critical in helping our team ensure that patients receive the necessary care without delay.

Schedule Details:

• Location: On-Site (Training will be held at our office in Orange, CA. After training, you will transition to working from our Laguna Hills, CA office.)


• Hours: Monday to Friday, 8:30 AM - 5:00 PM

Responsibilities:

• Obtain prior authorizations for medical and prescription services.


• Submit and manage authorization appeals as needed.


• Communicate effectively with healthcare providers, insurance companies, and patients to ensure authorization requests are processed efficiently.


• Track and document all authorization requests and approvals.


• Maintain up-to-date knowledge of insurance authorization requirements and procedures.


• Collaborate with the clinical team to resolve any issues related to authorizations and appeals.


• Ensure all authorizations are processed in accordance with company policies and regulatory guidelines.

Qualifications:

• Previous experience in prior authorization and appeals, ideally in a specialty pharmacy or specialty medical office.


• Solid knowledge of medical terminology, insurance processes, and prescription medications.


• Exceptional attention to detail and strong organizational skills.


• Ability to work independently while managing multiple tasks in a fast-paced environment.


• Excellent verbal and written communication skills.


• Proficient in Microsoft Office Suite and other healthcare-related software.

Preferred Skills:

• Experience with prior authorization and insurance appeals.


• Familiarity with healthcare claims processing.


• Strong problem-solving skills and the ability to analyze and resolve complex authorization and insurance-related issues.

AmeriPharma’s Mission Statement 

Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients, prescribers, colleagues, and others that We Care!

Physical Requirements 

The following physical activities described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions and expectations

EEO Statement 

The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.