Claims Support Coordinator (Prior Authorization)

Injured Workers Pharmacy • Andover, MA

9h • $22 - $25

About The Position

The Claims Support Coordinator (Prior Authorization) is responsible for ensuring that specific workers compensation claim prescriptions are processed accurately and in a timely manner in order to increase cash flow and meet or exceed production goals. This position demands strong communication skills, quality customer service, heavy telephone interaction, problem solving skills and strong attention to detail while working in a fast-paced team environment.

Requirements

• 1-2 years of experience of Prior Authorization, Healthcare or Pharmacy billing
• Excellent customer service skills
• Independent problem solver
• Detail oriented
• Microsoft Office Suite Knowledge (required)

Nice To Haves

• Basic knowledge of medical terminology (preferred)
• Basic knowledge of workers compensation (preferred)
• Pharmacy Technician License (preferred)

Responsibilities

• Documents all communication with insurance carriers, physicians, law firms, account managers and patients in the approved format
• Follow all department policies and procedures to obtain authorization and pertinent information
• Review all letters and medical documents in regard to prior authorization
• Serves as a liaison between departments and outside parties to ensure that customers receive their medication in a timely manner
• Obtaining prior authorization for pending medications in states which this is required
• Faxing documents to insurance carriers, physicians, law firms, account managers and other parties when requested
• Consistent awareness and comprehension of pre-adjudication and formulary prior authorization processes including staying up to date on all policy/procedure changes
• General understanding of prior authorizations rules and regulations in all states in which prior authorization is required
• Communicates effectively and articulates ideas verbally and in writing
• Accountable for actions and decisions demonstrated in daily tasks
• Maintains or exceeds the expected productivity and quality
• Notifies Supervisor of trends
• Perform other duties as assigned

Benefits

• Monthly engagement events and larger annual celebrations (tent party, summer BBQ, Family Fun Day)
• Tuition reimbursement and an internal-first job posting philosophy to support career growth
• Onsite fitness center, free parking, and a competitive benefits package
• A positive, inclusive environment where employees feel valued, supported, and empowered

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 11-50 employees