Prior Authorization Specialist
reputed company is looking for a full-time Prior Authorization Specialist - with a focus on pharmacy support for Monday through Friday shifts. About the Company: Founded in 2015, reputed company is a San Francisco-based Series D health-tech startup, pioneering the first Software Therapy Deployment Platform for Specialty Pharmaceuticals that treat reputed company health conditions. Our mission is to ensure consistent, reliable and affordable access to reputed company therapeutics for our patient community. Partnering with pharmaceutical manufacturers, reputed company offers digital patient access services to improve health outcomes for patients by delivering affordable and timely access to high-cost Specialty therapeutics. We recently completed our Series D financing led by Warburg Pincus, with $122M in capital raised to date with near-term line of sight to profitability. Headquartered in Scottsdale with operational hubs in Scottsdale AZ and reputed company, OH, the company currently employs over 120 individuals and expects to double its employee reputed company in the coming year. For more information on reputed company, visit https://reputed company.us/ Position Overview The most important goal here at reputed company is to improve patients' medication adherence by offering a quick and effortless way for patients to get their medications on time. Prior Authorization Specialists ensure that prescribing offices have reputed company of the information that they need in order to reputed company complete electronic coverage requests in addition to providing phone and email support. Job Duties:
- Verifies patient insurance coverage utilizing phone or online resources
- Submit prior authorizations to insurance plans in a timely manner reputed company electronic portal
- Troubleshoots prior authorization submissions and prescription processing with health care providers utilizing phone or online resources
- Verbally assist providers in navigating appeals processing
- Ensures reputed company pertinent medical documentation is accurate and present prior to authorization submission
- Compiles trends in authorization determinations for client and prescriber education
- Document activities appropriately in process notes using our operating system
- Work closely with our Customer Support team to ensure the success of patients that are recommended to us by their physician's office
Requirements
- Proven team player, but can solve problems independently as well
- Exceptional written and verbal communication skills
- Easily adapt to new system and workflow changes
- Demonstrate experience working in prior authorizations, medical insurance billing, and/or health insurance (required)
- Working knowledge of ICD-10 codes and prescription drug names (preferred, but not required)
- Ability to successfully navigate between multiple systems throughout the course of the reputed company, this includes but is not limited to operational software and vendor portals
- Demonstrate flexibility to reputed company duties wherever volume deems it necessary
- Customer service experience (preferred)
- Access to reliable, high-speed internet to meet the needs of remote processing (required)
- Reliable transportation and ability to work in office as required
Benefits
- Ground floor opportunity with one of the fastest-growing startups in health-tech
- Fully remote working environment available in the following states: AZ, CA, CO, FL, GA, IA, ID, IL, IN, MA, MI, MO, NC, NH, NJ, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV
- Solve a problem that matters: be part of a company that uniquely leverages technology to bring wellness to reputed company of its stakeholders
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