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RCO-Prior Authorization Claims Specialist


Lebanon, TN, US / Katy, TX, US
  • Job Type: Full-Time
  • Function: Operations
  • Industry: Healthcare Services
  • Post Date: 05/25/2023
  • Website:
  • Company Address: 150 Pierce Street, Somerset, NJ, 08873

About PharmScript

PharmScript provides superior pharmacy services in support of long-term and post-acute care facilities. We improve the accuracy, timeliness, accessibility, and efficiency of pharmacy services, consistently providing exemplary client service.

Job Description

PharmScript is one of the nation’s leading pharmacies, partnering with long-term and post- acute care facilities to supply medications to thousands of residents and patients. When you join the PharmScript family, you join the ranks of more than 1,700 dedicated people across the country who help to get safe, accurate, and timely medication to those who need it most.We’re looking for a RCO-Prior Authorization Claims Specialist to join our PharmScript team within our Revenue Cycle Operations department. The Prior Authorization Claims Specialist reports to the Prior Authorization Claims Supervisor within the Revenue Cycle Operations department.Theidealcandidateisapeoplepersonwhoenjoystroubleshootingandresolvingproblems and is dedicated to helping customers. For you, no task feels too small and no challenge impossible. Excellent communication and interpersonal skills areessential.


Key Responsibilities:

  • Responsible for the daily workflow of rejected prior authorization and non-formulary claims within compliant guidelines
  • Communicate directly with the Lead Prior Authorization Claims Specialist with all identified challenges, successes, and concerns from all internal and external customers
  • Communicate with other team members throughout RCO, operations, customer success and cost containment to deliver additional value to contracted long term care facilities
  • Work special projects as needed
  • Research and respond to customer billing issues/reports in timely manner
  • Maintain professional internal and external relationships that reflect the values of PharmScript



  • High school diploma
  • Experience with prior authorization/interchange adjudication
  • Able to work independently as well as in a diverse, team environment
  • Experience in long term care preferred
  • Technician certification


Skills and Abilities:

  • Able to identify and resolve issues quickly and efficiently
  • Excellent communication and organizational skills
  • Able to work under pressure and meet deadlines
  • Must be able to work in a fast-paced environment
  • Strong analytical, problem solving and strategic thinking skills
  • Ability to manage and develop diverse teams
  • Strong leadership and customer service skills
  • Moderate to advanced computer skills required
  • Proficient in Microsoft Office


EEO Statement:PharmScript is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation and gender identity or any other status protected by federal, state or local law.EO/Minorities/Females/Disabled/Veterans


USD $18.00/Yr.


USD $19.00/Yr.