Claims Support Coordinator (Prior Authorization)

IWP Careers•Andover, MA

3d•Onsite

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
Microsoft Office Suite Knowledge (required)
Ability to work a full-time schedule, Monday–Friday, 10:00 am to 6:30 pm, with two rotating days per week from 10:30am to 7:00 pm based on team needs.

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