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Prior Authorization Technician - Remote
<div><h4>Job Details</h4><div><strong>Job Location</strong>: Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL 33309</div><div><strong>Position Type</strong>: Full Time</div><div><strong>Job Category</strong>: Pharmaceutical</div></div><p style="margin-left:0in; margin-right:0in"><span style="font-size:16px"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#333333">PRIOR AUTHORIZATION SPECIALIST (REMOTE)</span></strong></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span calibri="" style="font-family:">WHO WE ARE</span></span></strong><br> <span style="font-size:11.0pt"><span calibri="" style="font-family:">At Polaris Pharmacy Services, we’re more than a pharmacy — we’re a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we’re raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.</span></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:11.0pt"><span calibri="" style="font-family:"> Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job — we provide competitive pay, robust benefits, and genuine opportunities for career advancement.</span></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:11.0pt"><span calibri="" style="font-family:">If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.</span></span></span></span></p> <p style="margin-left:0in; margin-right:0in"> </p> <p style="margin-left:0in; margin-right:0in"><span style="font-size:16px"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#333333">OVERVIEW</span></strong></span></span></p> <p style="margin-left:0in; margin-right:0in"><span style="font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior Authorization Specialist must be responsive and courteous when addressing our customers needs. Successful Specialists are dedicated to meeting the expectations and requirements of the position; understanding customer information and using it to improve products and services we deliver; talking and acting with customers in mind; establishing and maintaining effective relationships with co-workers and customers, thus gaining our customers trust and respect.</span></span></span></p> <p style="margin-left:0in; margin-right:0in"> </p> <p style="margin-left:0in; margin-right:0in"><span style="font-size:16px"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#333333">RESPONSIBILITIES</span></strong></span></span></p> <ul> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Research, analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Ensure approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Contact providers and/or customers as necessary to obtain additional information</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Monitor and resolve revenue at risk associated with payer set up, billing, rebilling, and reversal processes</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Work as a team to identify, document, communicate, and resolve payer/billing trends and issues</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Complete, communicate, and submit necessary payer paperwork, including but not limited to prior authorizations forms and manual billing in a timely manner</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Review and work convert billing exception reports to ensure claims are billed to accurate financial plans</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Complete billing transactions for non-standard order entry situations as required</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Support training needs</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Prepare and maintain reports and records for processing</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Perform other tasks as assigned.</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Follow all applicable government regulations, including HIPAA</span></span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Comply with departmental policies regarding safety, attendance, and dress code</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Overtime, holidays, and weekends may be required and/or expected</span></span></li> <li><span style="font-size:16px"><span style="font-family:Calibri,sans-serif">Conduct job responsibilities in accordance with the standards set out in the Companys Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards</span></span></li> <li><span style="font-size:16px"><span style="color:#333333"><span style="font-family:Calibri,sans-serif">Other duties as assigned; Job duties may vary depending on business needs</span></span></span></li> </ul> <h4>Qualifications</h4><br><p style="margin-left:0in; margin-right:0in"><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#333333">QUALIFICATIONS</span></strong></span></span></p> <ul> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">High School diploma or equivalent required</span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Minimum of one (1) or more years working as a pharmacy technician in a retail environment required (long-term care pharmacy preferred)</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Framework LTC & General computer knowledge & 10-key Number Entry preferred </span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Able to read, write, speak, and understand the English language</span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Able to retain a large amount of information and apply that knowledge to related situations </span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Able to work in a fast-paced environment</span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Basic computer knowledge skills required</span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Basic math and analytical skills</span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Experience with alpha-numeric data entry</span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Proficient in Microsoft Word, Excel, and Outlook required</span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Customer Service</span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Results-oriented</span></span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Good organization/Attention to detail</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Reliable</span> </span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Problem solver</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Able to work various shifts and days</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><span style="color:#333333">Adaptability to an ever-changing environment</span></span></span></li> </ul> <p style="margin-left:0in; margin-right:0in"> </p> <p style="margin-left:0in; margin-right:0in"><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#333333">PHYSICAL DEMANDS</span></strong></span></span></p> <p style="margin-left:0in; margin-right:0in"><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:</span></span></p> <p style="margin-left:0in; margin-right:0in"> </p> <ul> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">May sit or stand seven (7) to ten (10) hours per day</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, crouch, walk, crawl intermittently</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">May be necessary to work extended hours as needed</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">May lift and/or move up to 50 pounds</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role</span></span></li> </ul> <p style="margin-left:0in; margin-right:0in"> </p> <p style="margin-left:0in; margin-right:0in"><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#333333">HOLIDAY & PTO POLICY</span></strong></span></span></p> <ul> <li><span style="display:block; font-size:16px">Paid holidays are provided annually, with 6 days offered each year, along with 5 sick days.</span></li> <li><span style="display:block; font-size:16px">Employees earn up to 10 PTO days each year, with rollover options and milestone bonuses.</span></li> <li><span style="display:block; font-size:16px">Employees have the option to cash out up to 10 PTO hours each quarter for added financial flexibility.</span></li> </ul> <p style="margin-left:0in; margin-right:0in"><span style="display:block; font-size:16px"><strong><span style="font-family:Calibri,sans-serif">Please note we are a long-term care pharmacy open 24-hours a day, 7 days a week. <span style="color:#333333">And schedules may change as determined by the needs of the business.</span></span></strong></span></p> <p style="margin-left:0in; margin-right:0in"> </p> <p style="margin-left:0in; margin-right:0in"><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif"><strong>BENEFITS for full time employees</strong></span></span></p> <ul> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Medical, Dental, and Vision insurance</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">401 (k) (available for Part Time & Full Time EEs)</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Company Paid Life insurance </span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Short-term and Long-term disability insurance</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Tuition reimbursement</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Personal Time Off (PTO)</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Competitive pay with annual performance reviews and merit-based raises</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Career growth potential</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Annual on-site voluntary Flu Vaccine</span></span></li> <li><span style="display:block; font-size:16px"><span style="font-family:Calibri,sans-serif">Employee referral bonus program</span></span></li> </ul>