SupplyScape
Prior Authorization Specialist - Pharmacy Technician License Required
SupplyScape, Elk Grove Village, Illinois, us, 60009
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About Orsini Providing compassionate care since 1987, Orsini is a leader in rare disease and gene therapy pharmacy solutions, built to simplify how patients connect to advanced medicines. Through our comprehensive commercialization solutions including a nationwide specialty pharmacy, patient services hub, home infusion and nursing network, and third‑party logistics provider, we work with biopharma, providers, and payors to ensure No Patient is Left Behind™.
OUR MISSION Orsini is on a mission to be the essential partner for biopharma innovators, healthcare providers, and payers to support patients and their families in accessing revolutionary treatments for rare diseases. Through our integrated portfolio of services, we seek to pioneer comprehensive solutions that simplify how patients connect to advanced therapies while providing holistic, compassionate care so that No Patient is Left Behind™.
CORE VALUES At the heart of our company culture, the Orsini LIVE IT Core Values serve as guiding principles that shape how we interact with each other and those we serve. These values are the driving force behind our commitment to excellence, collaboration, and genuine care in every aspect of our work.
COMPENSATION & LOCATION The compensation range for this role is $19.00‑$23.00/hour, determined based on skills, experience, and qualifications. This a hybrid position based out of our Elk Grove Village, Illinois location that requires 2‑3 days in office. Travel to other locations may occur, although minimal.
Position Summary This position will work closely with the Benefits Verification Team to validate patient’s insurance plans, prescriptions, and eligibility. Responsibilities include reading prescriptions, converting prescriptions into authorizations, and interpreting medical policies. Prior Authorization Representatives are responsible for contacting physician’s offices to validate prescriptions, obtain clinical documentation, and initiate prior authorizations through insurance plans.
Essential Job Duties
Contact plans (PBM or Major Medical) to validate request sent from BV
Contact physician’s office to obtain current prescriptions
Contact physician’s office to obtain clinical documentation required by the plans
Validate that the clinical documentation received is what is required by the plan
Initiate prior authorizations through Cover My Meds
Follow up on all pending PA’s within 48 hours
Respond to urgent emails submitted by the Patient Care Coordinator Team or Program Manager in a timely manner
Obtain approval/denial letters
Submit all new Complex authorization approvals and/or Complex re‑authorization approvals through the Complex audit process
Initiate re‑authorizations that are set to expire 30 days prior to the term date
REQUIRED KNOWLEDGE, SKILLS, & TRAINING
Experience with Major Medical Insurance
Knowledge of Pharmacy Benefit
Knowledge of HCPC Codes (J‑Codes)
Knowledge of ICD‑10 Codes (Diagnoses Codes)
Familiar with medical documentation such as H&P’s, Genetic testing, etc
Ability to read prescriptions
Ability to convert a prescription into an authorization request based on payer requirements
Ability to interpret medical policies
EMPLOYEE BENEFITS
Medical Coverage, Dental, and Vision Coverage
401(k) with employer match
Accident and Critical Illness coverage
Company‑paid life insurance options
Generous PTO, paid holidays, and floating holidays
Tuition reimbursement program
Equal Employment Opportunity Orsini Rare Disease Pharmacy Solutions is committed to the principle of Equal Employment Opportunity for all employees and applicants. It is our policy to ensure that both current and prospective employees are afforded equal employment opportunity without consideration of race, religious creed, color, national origin, nationality, ancestry, age, sex, marital status, sexual orientation, or present or past disability (unless the nature and extent of the disability precludes performance of the essential functions of the job with or without a reasonable accommodation) in accordance with local, state and federal laws.
Americans with Disabilities Act Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case‑by‑case basis in accordance with applicable law.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Other
Industries Internet Publishing
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Get AI-powered advice on this job and more exclusive features.
About Orsini Providing compassionate care since 1987, Orsini is a leader in rare disease and gene therapy pharmacy solutions, built to simplify how patients connect to advanced medicines. Through our comprehensive commercialization solutions including a nationwide specialty pharmacy, patient services hub, home infusion and nursing network, and third‑party logistics provider, we work with biopharma, providers, and payors to ensure No Patient is Left Behind™.
OUR MISSION Orsini is on a mission to be the essential partner for biopharma innovators, healthcare providers, and payers to support patients and their families in accessing revolutionary treatments for rare diseases. Through our integrated portfolio of services, we seek to pioneer comprehensive solutions that simplify how patients connect to advanced therapies while providing holistic, compassionate care so that No Patient is Left Behind™.
CORE VALUES At the heart of our company culture, the Orsini LIVE IT Core Values serve as guiding principles that shape how we interact with each other and those we serve. These values are the driving force behind our commitment to excellence, collaboration, and genuine care in every aspect of our work.
COMPENSATION & LOCATION The compensation range for this role is $19.00‑$23.00/hour, determined based on skills, experience, and qualifications. This a hybrid position based out of our Elk Grove Village, Illinois location that requires 2‑3 days in office. Travel to other locations may occur, although minimal.
Position Summary This position will work closely with the Benefits Verification Team to validate patient’s insurance plans, prescriptions, and eligibility. Responsibilities include reading prescriptions, converting prescriptions into authorizations, and interpreting medical policies. Prior Authorization Representatives are responsible for contacting physician’s offices to validate prescriptions, obtain clinical documentation, and initiate prior authorizations through insurance plans.
Essential Job Duties
Contact plans (PBM or Major Medical) to validate request sent from BV
Contact physician’s office to obtain current prescriptions
Contact physician’s office to obtain clinical documentation required by the plans
Validate that the clinical documentation received is what is required by the plan
Initiate prior authorizations through Cover My Meds
Follow up on all pending PA’s within 48 hours
Respond to urgent emails submitted by the Patient Care Coordinator Team or Program Manager in a timely manner
Obtain approval/denial letters
Submit all new Complex authorization approvals and/or Complex re‑authorization approvals through the Complex audit process
Initiate re‑authorizations that are set to expire 30 days prior to the term date
REQUIRED KNOWLEDGE, SKILLS, & TRAINING
Experience with Major Medical Insurance
Knowledge of Pharmacy Benefit
Knowledge of HCPC Codes (J‑Codes)
Knowledge of ICD‑10 Codes (Diagnoses Codes)
Familiar with medical documentation such as H&P’s, Genetic testing, etc
Ability to read prescriptions
Ability to convert a prescription into an authorization request based on payer requirements
Ability to interpret medical policies
EMPLOYEE BENEFITS
Medical Coverage, Dental, and Vision Coverage
401(k) with employer match
Accident and Critical Illness coverage
Company‑paid life insurance options
Generous PTO, paid holidays, and floating holidays
Tuition reimbursement program
Equal Employment Opportunity Orsini Rare Disease Pharmacy Solutions is committed to the principle of Equal Employment Opportunity for all employees and applicants. It is our policy to ensure that both current and prospective employees are afforded equal employment opportunity without consideration of race, religious creed, color, national origin, nationality, ancestry, age, sex, marital status, sexual orientation, or present or past disability (unless the nature and extent of the disability precludes performance of the essential functions of the job with or without a reasonable accommodation) in accordance with local, state and federal laws.
Americans with Disabilities Act Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case‑by‑case basis in accordance with applicable law.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Other
Industries Internet Publishing
#J-18808-Ljbffr