Prior Authorization Specialist

US Digestive Health • Wyomissing, PA

10h • Onsite

About The Position

Effectively obtain insurance authorizations for patients prescribed medication. Responsible for authorizations in multi-provider practice. Obtain patient insurance information and contact insurance carriers online or by phone to verify requirements. Research clinical information from medical record needed to obtain prior authorizations from insurance companies or patient assistance programs. Communicating authorizations to patients and physicians explaining approvals or denials for medication when needed. Field any phone calls and emails related to authorizations. Establish relationships with drug companies.

Requirements

• High School Diploma or GED equivalent
• Excellent organizational and problem-solving skills
• Demonstrates well developed interpersonal/communication skills necessary to interact effectively with internal and external customers
• Ability to evaluate a variety of patient situations and make timely decisions
• Must demonstrate ability to work in fast-paced, deadline-oriented environment, with minimal supervision, with the ability to meet deadlines is a must with constant communication required
• Strong computer skills, including basic keyboarding, experience with Microsoft Office software (Outlook, Work, Excel)
• Ability to support and understand authorization processes
• Knowledge and/or willingness to understand insurance guidelines and requirements to successfully complete prior authorizations/pre-determinations
• Must be authorized to work in the US for any employer

Nice To Haves

• Minimum 3-5 years of experience in customer service preferred but not required.
• Prefer previous Medication Authorization responsibilities
• Allscripts EMR program a plus

Responsibilities

• Responsible for authorizations in multi-provider practice.
• Obtain patient insurance information and contact insurance carriers online or by phone to verify requirements.
• Research clinical information from medical record needed to obtain prior authorizations from insurance companies or patient assistance programs.
• Communicating authorizations to patients and physicians explaining approvals or denials for medication when needed.
• Field any phone calls and emails related to authorizations.
• Establish relationships with drug companies.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED