Prior Authorization Specialist [PBM Experience must]
Job Description
Job Description
Title: Prior Authorization Specialist
Location: HYBRID [1-2 day onsite per week to RenCen - Tower 500, Detroit, MI]
Duration: 8+ months
Role Overview
Support healthcare payer providers, including pharmacists and physicians, in analyzing Medicare Part D and/or commercial pharmacy and specialty drug benefits. Responsibilities include handling drug coverage inquiries and assisting with prior authorizations.
Key Responsibilities
- Support Medicare Part D and commercial pharmacy/specialty drug benefit analysis
- Respond to drug coverage and formulary inquiries
- Assist with prior authorization processing and follow-ups
- Interpret pharmacy claims and benefit information
- Communicate effectively with healthcare professionals and internal teams
- Use computer systems and Microsoft Office tools for documentation and workflow management
Required Skills & Experience
- Minimum 2 years of retail pharmacy experience
- Experience with pharmacy claim adjudication
- Strong customer service skills
- Basic knowledge of pharmacy and medical terminology
- Understanding of prescription drug names and therapeutic drug classes
- Computer literacy and Microsoft Office experience
Preferred Skills & Experience
- Certified Pharmacy Technician (PTCB) certification preferred
- Experience with Medicare Part D prescription drug benefits
- Experience in hospital pharmacy (optional advantage)
Education
- High School Diploma or GED required
- 2 years of college preferred
Company DescriptionFounded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.
At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.
Kyyba is an Equal Opportunity Employer.
Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b
Company Description
Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.\r\n\r\nAt Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.\r\n\r\nKyyba is an Equal Opportunity Employer.\r\n\r\nKyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b