Prior Authorization Specialist, Outpatient Pharmacy

The Prior Authorization (PA) Specialist is responsible for all aspects of the prior authorization process while continuously monitoring and ensuring compliance through established procedures and documentation. Responsibilities include collecting all the necessary documentation, contacting the client for additional information to complete the PA process. Complete, timely, and accurate identification and submission of prior and retro authorization requests to payors. Interacts with clients, insurance companies, patients, as necessary, to request for prior authorizations. Responsible for documenting account activity, updating patient and claim information and demonstrates proficiencies with Epic, CoverMyMeds, and other billing platforms to ensure all functionalities are utilized for the most efficient processing of claims and identifies PA trends and/or issues resulting in delayed claims processing. Provides the highest level of customer service to internal care teams and patients and families.

  

Required Education/Experience:

- High school graduate or G.E.D.

- Graduation from accredited pharmacy technician training program, or equivalent training.

- Minimum of three (3) years of retail or outpatient pharmacy practice experience.

Required Credentials:

- Licensed by the Washington State Pharmacy Department of Health as a pharmacy technician.

Preferred:

- One (1) year Seattle Children's Outpatient Pharmacy experience.

- Specialty Pharmacy and/or Centralized Prior Authorization Services knowledge.

Compensation Range

$31.28 - $46.93 per hour

Salary Information

This compensation range was calculated based on full-time employment (2080 hours worked per calendar year). Offers are determined by multiple factors including equity, skills, experience, and expertise, and may vary within the range provided.

Disclaimer for Out of State Applicants

This compensation range is specific to Seattle, positions located outside of Seattle may be compensated differently depending on various factors.

Benefits Information

Seattle Children’s offers a generous benefit package, including medical, dental, and vision plans, 403(b), life insurance, paid time off, tuition reimbursement, and more.  Additional details on our benefits can be found on our website www.seattlechildrens.org/careers/benefits.

About Us

Hope. Care. Cure. These three simple words capture what we do at Seattle Children’s – to help every child live the healthiest and most fulfilling life possible.  Are you ready to engage with a mission-driven organization that is life-changing to many, and touches the hearts of all? #HOPECARECURE

Our founding promise to the community is as valid today as it was over a century ago: we will care for all children in our region, regardless of the families’ ability to pay. Together, we deliver superior patient care, advance new discoveries and treatments through pediatric research, and serve as the pediatric and adolescent, academic medical center for Washington, Alaska, Montana and Idaho – the largest region of any children’s hospital in the country.
 
In 2022, U.S. News & World Report once again ranked Seattle Children’s among the nation’s best children’s hospitals – for the 30th year in a row. For more than a decade, Seattle Children’s has been nationally ranked in all 10 specialty areas evaluated by U.S. News & World Report. We are honored to be the top-ranked pediatric hospital in Washington and the Pacific Northwest.
 
As a Magnet designated institution, and classified among America’s best large employers by Forbes, we recognize the importance of hiring and developing great talent to provide best-in-class care to the patients and families we serve. Our organizational DNA takes form in our core values: Compassion, Excellence, Integrity, Collaboration, Equity and Innovation. Whether it’s delivering frontline care to our patients in a kind and caring manner, practicing the highest standards of quality and safety, or being relentlessly curious as we work towards eradicating childhood diseases, these values are the fabric of our culture and community. The future starts here.

Our Commitment to Diversity

Our community welcomes diverse experiences, backgrounds, and thoughts as this is what drives our spirit of inquiry and allows us to better connect with our increasingly diverse patients and families. Our organizatio