Prior Authorization Clerk

Curant Health•Smyrna, GA

1d•Onsite

About The Position

At Curant Health, our vision is Personalize healthcare driven by choice and defined by value. As a Curant Health employee, your role is to deliver on that vision every day by delivering excellent Customer Service, Personalize Care, Accountability, Innovation, and Integrity. You take initiative, set goals, and solve problems while collaborating with friends and colleagues. Together we make a meaningful impact on our patients lives. In return, Curant Health is committed to providing you competitive pay, excellent benefits, and an opportunity to make a difference each day as we strive to reach our vision to be the preferred health care partner by excelling in quality, service, and affordability. Curant Health, the leader in patient-centric chronic disease management via specialty pharmacy is searching for an Prior Authorization Clerk to join its team in Smyrna, GA. We are committed to improving patient health outcomes by offering a pharmacist-managed medication care program, comprehensive therapeutic monitoring and dependable home delivery of prescription drugs.

Requirements

Requires a high school diploma or its equivalent and at least one (1) year of experience in the field or in a related area, or board certification.
Must be registered as a Pharmacy Technician in the state which work will be conducted.

Nice To Haves

Experience in a retail pharmacy environment is preferred.
Experience in prior experience with performing Prior Authorizations within the pharmacy, pharmacy benefit insurance or PBM field preferred.
Knowledge of PBM industry, formulary management, pharmacy claims and managed care principles and practices is a plus.
340B knowledge is strongly preferred
PTCB certification a plus but not required.

Responsibilities

Maintain complete, timely, and accurate documentation of all prior authorization approvals and denials within MedPlan and Curant Health’s pharmacy software system and shared drive.
Transfer all clinical questions and judgment calls to the prior authorization pharmacist.
Manage and triage appropriately provider faxes.
Initiate outbound communication with external parties and providers and monitor requests for PA related documents that are still outstanding or missing.
Respond to inquiries as needed regarding requested PA documents.
Upload provider PA Consent forms to the appropriate patient’s MedPlan profile.
Utilize appropriate courteous and professional behavior based upon established standards with both internal and external customers.
Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information.
Manage written or formal documentation to patients and providers on prior authorization status.
Create patient Prior Authorization folders appropriately in the Share Drive.
Collaborate with fellow Prior Authorization team members to provide administrative support.