phil - Prior Authorization Specialist
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Requirements
• Proven team player, but can solve problems independently as well • Exceptional written and verbal communication skills • Easily adapt to new system and workflow changes • Demonstrate experience working in prior authorizations, medical insurance billing, and/or health insurance (required) • Working knowledge of ICD-10 codes and prescription drug names (preferred, but not required) • Ability to successfully navigate between multiple systems throughout the course of the workday, this includes but is not limited to operational software and vendor portals • Demonstrate flexibility to perform duties wherever volume deems it necessary • Customer service experience (preferred) • Access to reliable, high-speed internet to meet the needs of remote processing (required) • Reliable transportation and ability to work in office as required
Responsibilities
• Verifies patient insurance coverage utilizing phone or online resources • Submit prior authorizations to insurance plans in a timely manner via electronic portal • Troubleshoots prior authorization submissions and prescription processing with health care providers utilizing phone or online resources • Verbally assist providers in navigating appeals processing • Ensures all pertinent medical documentation is accurate and present prior to authorization submission • Compiles trends in authorization determinations for client and prescriber education • Document activities appropriately in process notes using our operating system • Work closely with our Customer Support team to ensure the success of patients that are recommended to us by their physician's office
Benefits
• $19 – $22 per hour • Upload your resume here to autofill key application fields. • Drop your resume here! • Parsing your resume. Autofilling key fields... • or drag and drop here • What is your experience with prescription prior authorizations? • I prefer not to answer • Another Gender Identity • Heterosexual / straight • Asian or Asian American • Black or African American • Hispanic or Latine • Indigenous or Native American • Native Hawaiian or Other Pacific Islander • Person with disability • Refugee or immigrant • None of the above • Decline to self-identify • Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race. • Hispanic or Latino • White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. • White • Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa. • Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands. • Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. • Asian • American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment. • American Indian or Alaska Native • Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races. • Two or More Races • Hispanic or Latino • White (Not Hispanic or Latino) • Black or African American (Not Hispanic or Latino) • Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) • Asian (Not Hispanic or Latino) • American Indian or Alaska Native (Not Hispanic or Latino) • Two or More Races (Not Hispanic or Latino) • I identify as one or more of the classifications of protected veteran listed above • I am not a protected veteran
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