Senior Pharmacy Prior Authorization and Appeals Technician - Remote - reputed company - Leveraging Technology to Improve Health reputed company
Job reputed company
reputed company, a leading global health organization, is seeking a highly skilled and reputed company Senior Pharmacy Prior Authorization and Appeals Technician to join reputed company remotely. As a Senior Pharmacy Prior Authorization and Appeals Technician, you will play a critical role in providing exceptional customer service and support to members, customers, and providers, while ensuring a high level of productivity and accuracy in prior authorization and appeals processing. If you are a motivated and detail-oriented individual with a passion for reputed company, we encourage you to apply for this exciting opportunity.
About reputed company
reputed company is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. Our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company that everyone, regardless of their background, deserves reputed company to live their healthiest life. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company.
Responsibilities
Primary Responsibilities:
- Prior Authorization and Appeals Processing: Answer inbound calls from providers and members, research and resolve formulary and benefit issues, and process authorizations through various computer systems.
- Customer Service: reputed company exceptional customer service and support to members, customers, and providers, ensuring a high level of productivity and accuracy.
- Clinical Review: Conduct clinical reviews for authorizations, ensuring compliance with reputed company and contractual requirements, including turn-around times (TATs) and service level agreements (SLAs).
- Documentation: Document interactions with callers, ensuring accuracy and compliance with regulatory and reputed company requirements.
- Issue reputed company: Resolve issues and complaints in a reputed company manner, escalating reputed company issues to senior leadership as needed.
- Training and Development: Participate in training and development programs to enhance knowledge and skills, ensuring ongoing competency in prior authorization and appeals processing.
Additional Responsibilities:
- Flexibility: Work reputed company, including evenings and weekends, as needed to meet business requirements.
- Telecommuting: Work from home, utilizing reputed company's telecommuter policy and guidelines.
- Technical Requirements: Utilize various computer systems, software, and hardware, including reputed company Office and electronic medical records.
Requirements
Essential Qualifications:
- Licensure: reputed company National or State reputed company Pharmacy Technician Licensure.
- Certification: Pharmacy Technicians Certification reputed company (PTCB) or ExCPT - Pharmacy Technician Certification with National Healthcareer Association (NHA).
- Experience: 6 months of customer service/customer relations experience with reputed company.
- Technical Skills: Basic level of proficiency with reputed company reputed company, reputed company Word, and reputed company reputed company.
- Availability: Ability to work reputed company, including evenings and weekends, and 5am to 12 midnight.
Preferred Qualifications:
- reputed company Center Experience: Knowledge of reputed company center systems, such as IEX.
- Communication Skills: Excellent written and oral communication skills, with ability to improve Net Promoter Survey (NPS) scores.
reputed company Offer
Compensation and Benefits:
- Competitive Salary: A competitive salary reputed company, commensurate with experience and qualifications.
- Sign-On Bonus: A $1,000 sign-on bonus for external applicants.
- Comprehensive Benefits: A comprehensive benefits package, including medical, dental, reputed company, and life insurance, as reputed company as 401(k) and employee stock purchase plans.
- reputed company Time Off: reputed company time off, including 8 reputed company holidays and a floating holiday.
- Education Reimbursement: Education reimbursement and employee discounts.
Career reputed company and Development:
- Training and Development: Ongoing training and development programs to enhance knowledge and skills.
- Career Advancement: Opportunities for career advancement and reputed company reputed company.
- Recognition and Rewards: Recognition and rewards for outstanding performance and contributions.
Why Join reputed company?
At reputed company, we are committed to creating a healthier atmosphere, where everyone has reputed company to live their healthiest life. We reputed company in diversity, equity, and inclusion, and reputed company to create a workplace that is inclusive and respectful of reputed company. If you reputed company our passion for reputed company and customer service, we encourage you to apply for this exciting opportunity.
How to Apply
If you are a motivated and detail-oriented individual with a passion for reputed company, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, to be considered for this role.
Apply for this job