- Review and assess medication requests for prior authorization
- Verify the medical necessity and appropriateness of prescribed medications
- Communicate with healthcare providers to gather necessary clinical information
- Evaluate insurance coverage and formulary restrictions
- Collaborate with healthcare professionals to find suitable alternative treatments
- Prepare and submit prior authorization requests to insurance companies
- Monitor the status of prior authorization requests and follow up as needed
- Maintain accurate records of all prior authorization interactions and outcomes
- Stay updated on insurance policies, regulations, and industry trends
- Provide guidance and education to patients and healthcare providers regarding prior
A
Apothecary of Medical Associates
Pharmacist In Charge
Schulenburg, TX, US
December 2019 - July 2023
M
Medication Managers
Consulting Pharmacist
Houston, TX, US
September 2018 - December 2020
S
Sealy Pharmacy
Long term care pharmacist
Sealy, TX, US
September 2018 - December 2019
Skills
Advanced Cardiovascular Life Support (ACLS)Alternative MedicineAssisted LivingAuditing SkillsClinical PharmacyCommunication SkillsConsultingHealth AdministrationHealth CareHospital Information SystemsInsurance Management and AftercareKnowledge of ImmunizationLife SupportLong-Term CareMedical Necessity DoctrineMedical PrescriptionsMedicationsMicrosoft AccessNursingPatient EducationPatient Information LeafletsPharmacoinformaticsPublic HealthStock ControlTask Management