Prescription Prior Authorization Representative - Remote

Overview

The Prescription Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.

In Short

• Assists with medical necessity documentation to expedite approvals.
• Follows prior authorization workflow and policies.
• Collaborates with other departments for prior authorizations.
• Reviews accuracy and completeness of requested information.
• Receives and monitors prior authorization requests.
• Consults with supervisor or pharmacist for treatment clearance.
• Processes referrals and submits clinical documentation to insurance.
• Manages correspondence with insurance companies and patients.
• Documents prior authorization information in patient profiles.
• Provides superior customer service excellence.

Requirements

• Medical Assistant experience or equivalent medical background.
• Ability to read, write and interpret medical terminology.
• Ability to speak other languages is a plus.

Benefits

• Dynamic team environment.
• Opportunity to help others in healthcare.
• Flexible work arrangements after training.