Nycancer

Why Join Our Team?
At New York Cancer &amp; Blood Specialists (NYCBS), we are dedicated to making a difference in the lives of our patients, their families, and our communities. Our passionate team of expert oncologists, hematologists, and healthcare professionals work together to provide world-class cancer care close to home. By offering cutting-edge treatments, innovative research, and a patient-centered approach, we are redefining what’s possible in the fight against cancer and blood disorders.
If you want to be part of a growing organization committed to healing, hope, and advanced care, join us and help make a meaningful impact!
Job Description:
<h3>In This Role, You Will:</h3>
<ul>
<li>Run and work daily Business Office Report in OncoEMR for drug order values: POD Verify and</li>
<li>NYCBS Pharm Fill for current date of service and one week out to be worked to obtain prior</li>
<li>authorizations. All STAT orders are to be worked immediately upon request by onsite team.</li>
<li>Work daily requests from onsite pharmacy dispensaries to obtain prior authorization on</li>
<li>requested medication.</li>
<li>Document notes in the Sig Box of OncoEMR in the patient’s treatment plan including approval</li>
<li>status or in text note where applicable. Must document all steps taken in research/process of the</li>
<li>case</li>
<li>Prepare appeals for denials on prior authorization requests where applicable.</li>
<li>Refer prescription fill requests that are denied or that have a patient financial responsibility to the</li>
<li>pharmacy financial counselor for review.</li>
<li>Ensure that all aspects of approval have been checked regarding prior authorization, pre-</li>
<li>determination, and pre-certification before approving the order as meeting NYCBS policy.</li>
<li>Verify patient’s own drug with pharmacy related queries where applicable.</li>
<li>Notify Nursing Management if orders need to be changed to BB (patient’s own drug) or to</li>
<li>Buy/Bill (billing through medical insurance)</li>
<li>Work any prior authorization requests from local pharmacies on patient’s oral medications or on</li>
<li>specialty pharmacy drugs.</li>
<li>Maintain and ensure the confidentiality of all patient and employee information at all times.</li>
<li>A pharmacy authorization specialist will be expected to work when given sufficient notice of</li>
<li>required overtime.</li>
</ul>
<h3>We Require:</h3>
<ul>
<li>High school or GED required.</li>
<li>Experience in pharmacy / authorization field.</li>
<li>Experience working in the healthcare field, preferably in a clinical setting or business office.</li>
<li>Experience in insurance requirements and medical terminology ICD-10 and CPT coding.</li>
<li>Experience in billing practice management systems, electronic medical record systems, Microsoft</li>
<li>Word, and Microsoft Excel.</li>
<li>Excellent verbal and communication skills between co-workers, physicians, management staff,</li>
<li>patients, insurances, outside programs.</li>
<li>Ability to multitask, problem solve, utilize basic math skills and follow complex instructions.</li>
<li>Must have ability to converse in a calm and friendly manner.</li>
<li>Able to relate and comfort patients during a difficult time.</li>
</ul>

Specialist, Pharmacy Authorization

Specialist, Pharmacy Authorization

This job is no longer available

Talents

Recruiters

About