PRIOR AUTHORIZATION JOB SUMMARY:

• Take in-bound calls from providers, pharmacies, members, etc., providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete timely and accurate documentation of reviews.
• Transfers all clinical questions escalations and judgement calls to the pharmacist team.
• Assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing prior authorizations received via fax and ePA monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.

PRIOR AUTHORIZATION HIGHLIGHTS:

• Work Schedule: Must be available for any 8-hour shift M-F between 7AM - 9PM EST with weekend rotation 7AM - 330PM
• 100% REMOTE!  Can live ANYWHERE in the USA.
• Start Date: 10/09/2023
• Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance
• 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates
• The compensation for this position is $17.50 per hour- paid biweekly

PRIOR AUTHORIZATION QUALIFICATIONS:

• High school diploma or GED required
• Experience working with a health plan OR specialty pharmacy performing prior authorizations is REQUIRED
• Data Entry experience
• 1 year of experience working REMOTE or in a high-volume call center

PLEASE CALL OR TEXT: Alliston Brown @ 5856-710-7944

Call center, customer service, PBM, pharmacy benefit management, insurance verification, benefit verification, Medicare D, Medicare B, insurance authorizations, mail order pharmacy, remote, work from home, pharmacy coordinator, insurance, claims, appeals, denials, medical, healthcare, customer service, team lead, supervisor, call center, telecommunications, managed care, health plan, prior authorizations

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