Under general direction, provides quality patient care to patients regarding Prior Authorizations and general medication inquiries. Responsibilities include, obtaining prior-authorizations, following up and communicating with patients as to the status of their prior-authorization, and working with insurance companies, pharmacy phone calls and patient calls related to medication issues.
Essential Duties and Responsibilities:
- Performs job in accordance with Company Mission, vision, and goals.
- Exercises confidentiality in all areas; abiding by HIPAA rules and regulations.
- Accurately completes applicable documentation as required for the completion of prior-authorizations.
- Prepares all forms and requisitions as need by insurance companies and pharmacies.
- Follows through to ensure that all prior-authorizations are submitted in a timely manner and followed up on within 72 business hours.
- Obtains prior-authorization for prescriptions.
- Monitors and maintains the task buckets associated with prior-authorizations and medication issues.
- Ensures accuracy of all forms submitted to the insurance companies and pharmacies.
- Provides professional and courteous customer/patient care; displaying knowledge and enthusiasm for the treatment approach.
- Expedites service in situations requiring urgent attention to medications and prior authorizations.
- Maintains high-level of product and service knowledge.
- Identifies opportunities for process improvement and contributes to solutions to enhance workflow efficiency and the customer’s/patient’s experience.
- Communicates medication denials and medication issues, as well as next steps, to appropriate staff.
- Checks work e-mail on a regular basis throughout the workday.
- Participate in and complete all required trainings and in-services.
- Other duties as assigned.
Minimum Qualifications:
- High School Diploma or equivalent.
- At least two (2) years of related experience working as a Medical Assistant or Nursing Assistant.
- Must have knowledge of Internet and Microsoft Office software (MS Word, MS Excel, MS PowerPoint, MS Outlook).
- Must have excellent written and oral communication skills.
- Must be able to work individually as well as within a team.
- Must be able to multi-task and prioritize.
- Must demonstrate extreme attention to detail.
- Must possess strong organization skills.
- Must be able to perform calculations, problem solve and use reasoning.
- Must have knowledge of medical practices and medical terminology.
- Must be able to meet predefined production and quality standards.
- Must be able to effectively manage and direct others.
- All staff are expected to have a strong desire to provide excellent customer service; to comply with the rules and regulations of those organizations to which we are accountable; to have high ethical and professional standards of conduct; and to have an attitude of wanting to continuously improve their own professional performance.
Compensation and Benefits:
- Pay Range: $18.00/Hr - $21.00/Hr
- PTO: Up to 96 hours in first year (pro-rated based on start date)
- Holidays: 7 (New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, Day After Thanksgiving, Christmas Day)
- Retirement: 401(k) with employer match
- Health Benefits: Medical (single and family), Dental (single and family), Vision (single and family)
- Other Company-Paid Benefits: Short-Term Disability, Long-Term Disability, Basic Life/AD&D, Employee Assistance Program
- Other Voluntary Benefits: Voluntary Life, Accident, Critical Illness, Hospital Indemnity