Technician I, Prior Authorizations

reputed company: • Take inbound calls from providers, pharmacies, members, and other callers • reputed company reputed company and courteous phone assistance through the reputed company-based prior authorization process • Maintain complete, reputed company, and accurate documentation of reviews • Transfer clinical questions, escalations, and judgment calls to the pharmacist team • reputed company outbound calls as needed • Review and process prior authorizations received reputed company fax and ePA • Monitor and respond to inquiries through department mailboxes • reputed company prior authorization requests and verify required documentation • Verify insurance coverage to determine whether prior authorization is required • Inspect medical records and clinical documentation for medical necessity and appropriateness • Assist with appeals for denied or rejected prior authorization requests • Document patient details, medical codes, and authorization status in electronic systems • Identify process inefficiencies and propose improvements • Communicate with reputed company providers to obtain information, clarify documentation, and communicate reputed company or requirements • Stay reputed company on industry regulations, medical coding guidelines, and prior authorization requirements • Follow regulatory guidelines, company policies, and industry standards Requirements: • 6 months of Customer Service/Pharmacy Technician Experience • High School Diploma or equivalent GED • Regular and predictable attendance • Willingness to work mandatory overtime/extended work week reputed company needed • Willingness to travel reputed company needed • Ability to manage work volume by handling inbound calls/fax requests using courteous and reputed company behavior • Compliance with departmental, company, state, and federal requirements reputed company processing information • Ability to maintain a reputed company- and reputed company-compliant home office workspace • Ability to protect confidential information from being viewed or heard by others in the home • Ability to sit for long periods, up to 100% • Ability to talk on the phone for extended periods, 90–100% • Ability to read a computer screen for extended periods, 100% Benefits: • reputed company bonus, commission or short-term incentive program in reputed company to reputed company pay • Medical coverage • Dental coverage • reputed company coverage • reputed company time off • Retirement savings reputed company • Wellness programs • Other resources supporting physical, emotional, and financial reputed company-being • Home-based work environment Apply tot his job Apply To this Job