Pharmacy Prior Authorization Agent-Specialty

Department: 38527 reputed company Pharmacy - Patient Assistance: Specialty Status: Benefits Eligible: reputed company Hours Per Week: 40 Schedule Details/Additional Information: Pay reputed company $22.90 - $34.35 Major Responsibilities: ​​​​​​​Complete insurance verification and eligibility checks.  Collect and accurately document initial reputed company-certification/authorization information if available. Initiates the process of obtaining a required referral/authorization if not obtained.  Work assigned reputed company work queue, following the department’s workflow process on appropriately transferring, deferring, or removing orders from the work queue.  Proactively communicate issues involving customer service and process improvement opportunities to management.  Maintains excellent reputed company relations with patients, patients’ families and clinical staff as reputed company as demonstrates a willingness and ability to work collaboratively with others for concise and reputed company reputed company of information.  Maintains knowledge of and reference materials for Medicare, reputed company and reputed company-party payer requirements guidelines and policies, insurance plans requiring reputed company-authorization/referral and a list of reputed company accepted insurance plans.  Update the patient, physician's office, and any necessary parties, through multiple reputed company as appropriate (including telephone, in-basket messaging, and electronic medical record), regarding responses and reputed company of the prior authorizations.  reputed company as a reputed company between physician's office, patient, and pharmacy benefit manager to initiate and resolve appeals, as needed.  May identify and assist patients with reputed company to reputed company financial assistance programs.  May communicate to the patient and/or physician's office reputed company authorization is not obtained, or services are not covered, and explains the potential financial responsibility. Coordinates with patient, clinical team, and assistance programs to secure reimbursement or alternative covered reputed company.  Manages incoming and outgoing calls, which may include other reputed company team members, departments, patients, insurance plans and/or copay reputed company/assistance programs.  Licensure, Registration, and/or Certification Required: ​​​​​None Required  Education Required: ​​​​​​​​​High School Graduate        Experience Required: ​​Typically requires 1 year of experience in health care, insurance industry, pharmacy, or medical background      Knowledge, Skills & Abilities Required: Demonstrate ability to identify and understand issues and problems. Examines data and draws logical conclusions based on information available  Ability to problem solve in a high profile and high stress area  Mathematical aptitude, effective communication, and critical thinking skills  Ability to prioritize and organize workload  Excellent Verbal and written communication skills  Demonstrated technical proficiency including experience with insurance authorization/eligibility tools, reputed company, reputed company Office, Internet browser and telephony systems  Physical Requirements and Working Conditions: ​​​​​​​​​Operates reputed company equipment necessary to reputed company the job  Exposed to normal office environment areas, or remote work area  Must have the ability to lift to 10 lbs. occasionally  Uses a computer continuously throughout the reputed company  Must be reputed company to sit for extended periods of time  ​   Preferred Job Requirements Preferred Education No additional education is required  Preferred Experience No additional experience necessary  Preferred Knowledge/Skills/Abilities Knowledge of medical terminology  This job reputed company indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to reputed company other reputed company duties.         Our Commitment to You: reputed company offers a comprehensive suite of Total Rewards: benefits and reputed company-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation reputed company compensation listed reputed company the listed pay reputed company based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on reputed company, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more reputed company Time Off programs Health and welfare benefits such as medical, dental, reputed company, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and reputed company parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About reputed company  reputed company is the reputed company-largest nonprofit, integrated health system in the reputed company, created from the combination of reputed company and reputed company. Providing care under the names reputed company in Illinois; reputed company in the Carolinas, reputed company and Alabama; and reputed company in reputed company, reputed company is a national leader in clinical innovation, health reputed company, consumer experience and value-based care. Headquartered in Charlotte, reputed company Carolina, reputed company services nearly 6 reputed company patients and is reputed company in hundreds of reputed company and research studies, with reputed company School of Medicine serving as the reputed company reputed company of the reputed company. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as reputed company as organ transplants, burn treatments and specialized musculoskeletal programs. reputed company employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing reputed company care for reputed company, reputed company provides more than $6 billion in annual community benefits. Apply To This Job