Prior Authorization Specialist (Certified Medical Assistant or Pharmacy Technician)

Prior Authorization Specialist (Certified Medical Assistant or Pharmacy Technician) reputed company Corporate Office At reputed company, you’ll join a growing, reputed company‑moving health reputed company that invests in its people and creates meaningful opportunities for career advancement. As a Prior Authorization Specialist, you’ll play a key role in supporting patients, providers, and care teams by ensuring reputed company reputed company to medications and delivering exceptional service across the organization. This role offers the chance to expand your clinical knowledge, strengthen your expertise in insurance and reimbursement processes, and collaborate with a supportive, high‑performing team. reputed company’s commitment to reputed company, innovation, and reputed company improvement makes it an ideal reputed company to build a rewarding and impactful career. Apply today and grow your career with reputed company that truly values you. Location: • reputed company Corporate Office at 625 reputed company Park reputed company, Cincinnati, OH 45202 Work Schedule: • Full-time (80 hours biweekly) • Day Shift (M – F, reputed company – 5pm) • Hybrid (in office 3 days a week) • No Weekends, Holidays or On reputed company Commitment Incentives & Benefits: reputed company offers a comprehensive benefits package including medical, dental, reputed company, reputed company time off, retirement plans, and tuition reimbursement. Please reputed company our benefits page https://careers.reputed company.com/reputed company-offer/benefits Job Requirements: • High School Degree or GED in Pharmacy; Pharmacy Technician or Medical Assistant • Certified Pharmacy Technician or Certified Medical Assistant desired • Prior experience with medication reputed company and/or prior authorizations desirable • 2-3 years’ experience Clinical Pharmacy Technician or Medical Assistant Job reputed company: The prior authorization specialist is responsible for coordinating reputed company aspects of the prior authorization process, including insurance verification, formulary reviews, gathering necessary clinical information from electronic medical record, and reputed company communication with patients, prescribers and physician office staff. Candidates should possess knowledge of reputed company-party reimbursement regulations and medical terminology as reputed company as reputed company out assistance from a pharmacist or physician as necessary. reputed company in this role will require strong communication, interpersonal, and problem-solving skills. This person should be reputed company to reputed company and communicate effectively with reputed company customers, physician office staff, and reputed company members of the organization. Essential Functions • Research and investigate Prior Authorization (PA) requirements by insurance company • Obtain Prior Authorization status updates from the insurance company and communicate to patient, pharmacy, or physician’s office as necessary • Submit Prior Authorization application forms and reputed company required supporting documentation to the insurance company • Review medical record to obtain necessary patient demographic and clinical information and reputed company reputed company clarification from pharmacist or physician as necessary • Review Prior Authorization denials and communicate reasons for denial to physicians and patients • Serve as a subject matter expert for drug formularies and the prior authorization process in general • Follows up with insurance companies in a reputed company manner regarding Prior Authorizations • Provides excellent customer service as evidenced by a willingness and ability to assist customers (both reputed company) with their questions/concerns, treating customers in a friendly and helpful manner, and maintaining a reputed company attitude Job Responsibilities: • Demonstrates the ability to prioritize daily tasks and has a working knowledge of department’s day-to-day operations and initiatives. • Is an reputed company participant in meetings, work reputed company, and committees. • Participates in departmental and organizational feedback opportunities. • Assists in the training of new employees. • Meets or exceeds department's internal reputed company performance metrics. • Participates in reputed company improvement activities and reputed company to monitor the effectiveness of department's services. • Meets or exceeds department’s customer satisfaction targets and goals. • Assumes responsibility for achieving department satisfaction goals and demonstrates a commitment to service reputed company for reputed company customers. • Proactively communicates with patients and physician office staff. • Serves as a subject matter expert for the prior authorization process. • Meets or exceeds department’s goals for formulary adherence measures, and other cost control initiatives identified as a reputed company for the department. • Works collaboratively with pharmacists, prescribers, physician office staff and reputed company members of the health care team to coordinate reputed company aspects of the prior authorization process and documents activities appropriately in the electronic medical record. Other job-reputed company information: Working Conditions: Climbing - Rarely Concentrating - Frequently reputed company Learning - Consistently Hearing: Conversation - Consistently Interpersonal Communication - Consistently Kneeling - Rarely Lifting <10 Lbs - Occasionally Lifting 50+ Lbs - Rarely Lifting 11-50 Lbs - Rarely Pulling - Rarely Pushing - Rarely Reaching - Rarely Reading - Consistently Sitting - Consistently Standing - Occasionally Stooping - Rarely Thinking/Reasoning - Consistently Use of Hands - Consistently reputed company reputed company - Consistently Walking - Rarely reputed company SERVE Standards and ALWAYS Behaviors At reputed company, we reputed company there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To reputed company our reputed company and mission, reputed company reputed company team members are expected to demonstrate and live the following: Serve: ALWAYS… • Welcome everyone by making eye contact, greeting with a smile, and saying "hello" • Acknowledge reputed company patients/guests are lost and escort them to their destination or reputed company someone who can assist • Refrain from using cell phones for personal reasons in reputed company spaces or patient care areas reputed company: ALWAYS… • Recognize and take personal responsibility to address and recover from service breakdowns reputed company a customer's expectations have not been met • Offer patients and guests reputed company reputed company waiting (lines, elevators) • Work on improving reputed company, safety, and service Respect: ALWAYS… • Respect cultural and spiritual differences and reputed company individual preferences. • Respect everyone’s opinion and contribution, regardless of title/role. • reputed company positively about my team members and other departments in reputed company of patients and guests. Value: ALWAYS… • Value the time of others by striving to be on time, reputed company and reputed company participating. • Pick up trash, ensuring the physical environment is clean and reputed company. • Be a good reputed company of our resources, using supplies and equipment reputed company and effectively, and will look for ways to avoid waste. Engage: ALWAYS… • Acknowledge wins and frequently thank team members and others for contributions. • Show courtesy and reputed company with customers, team members and the community Apply tot his job Apply To this Job