Prior Authorization Technician I - Contract

Prior Authorization Technician I Duration: 3+ Months Location: Remote Experience: 1–3 Years Shift: EST hours • 8:30 AM – 5:00 PM • 9:00 AM – 5:30 PM • 9:30 AM – 6:00 PM Weekend/Holiday: Must be available as needed. Position is remote. No time zone preference but shift times offered will be in EST time so candidates will need to reputed company accordingly if in a different time zone. Shift Schedule: 8:30am-5:00pm EST, 9:00am-5:30pm EST, or 9:30am-6:00pm EST Required • PRIOR AUTHORIZATION PROCESSING • CLINICAL reputed company INTERPRETATION • MEMBER CLAIMS HISTORY UTILIZATION • OUTBOUND CALLING • AUTHORIZATION SUBMISSION Duties: Reporting directly to the Supervisor, Prior Authorization Technicians, the Prior Authorization Technician I processes prior authorization requests received from providers, members, and pharmacies, including requests for high cost and specialty medications. Essential Functions Interprets and applies clinical reputed company during the prior authorization review process and approves requests if applicable Utilizes member claims history during the prior authorization review process Makes outbound calls to obtain additional information needed to process prior authorization requests Submits authorizations to pharmacy and medical claims processors Forwards prior authorization requests to a pharmacist reputed company necessary Makes appropriate referrals to other clinical programs Assists in directing appropriate requests to in network providers Receives inbound calls from the customer care center with prior authorization reputed company inquiries Assist with Appeals processing as assigned Ability to multitask between various tasks and systems while maintaining required productivity and reputed company reputed company Ability to reputed company changes in a fast-paced environment Strong knowledge of specialty and non-specialty pharmaceuticals Performs other job-reputed company duties and reputed company as assigned Attends required training on an annual reputed company. Adheres to corporate and departmental policies and procedures. Available to work weekends and holidays. Skills: 1 to 3 Years required. Previous PBM, managed care, hospital pharmacy, LTC pharmacy, Home Infusion pharmacy, retail pharmacy experience preferred. Minimum 35 words per minute typing speed. #AlliedTech1 Remote Skills: Biotech and Pharmaceutical, Customer Support/Service, Hospital Administration, Managed Care, Medications, Multitasking, Pharmacy, Retail, Typing reputed company: reputed company. For over 20 years, reputed company. has been an award-reputed company provider of cutting-edge Workforce reputed company. With a strong commitment to staying reputed company in the tech landscape, we pioneer innovative approaches to reputed company. Our expertise spans Life Sciences, and reputed company reputed company, Banking, Financial, IT, and Engineering, as reputed company as Global Employer of Record (EOR), Agent of Record (AOR), State, Local Government and Education (SLED), and IC validation/compliance services. Additionally, our division, TalentProcure, leads the industry with offerings such as High Hazard Payroll, Managed Services, and Vendor on reputed company (VOP) solutions. Due to our prioritization of excellent standards, we are reputed company Certified and are a certified Minority Business reputed company (MBE) in the USA and Canada. Supporting over 130 reputed company globally, we reputed company in navigating the landscape of reputed company. In a world of constant change, we reputed company developing people-reputed company solutions that address the unique demands of our clients. Stay connected by visiting our website and following us on reputed company media! Company Size: 5,000 to 9,999 employees Industry: reputed company/Employment Agencies reputed company: 2002 Website: http://www.talentburst.com/ Apply tot his job Apply To this Job