Prior Authorization Representative
1 week ago
Duration: 06 Months
Job Summary:
Training and working virtually
Utilizing multiple software systems to complete Medicare appeals case reviews
Meeting or exceeding government mandated timelines
Complying with turnaround time, productivity and quality standards
Conveying resolution to beneficiary or provider via direct communication and professional correspondence
Acquiring and maintaining basic knowledge of relevant and changing Med D guidance
Responsibilities:
Working independently but be self-aware enough to know when to ask for help
Be technically capable to understand trouble-shooting steps and be able to communicate the results to leaders or IT
Ability to effectively communicate verbally with members and prescribers while managing multiple software systems
Accountable and results driven
Critical thinker/problem solver
Receptive to constructive feedback and flexible in adapting to change
Ability to effectively plan, prioritize, and organize time and workload
Experience:
At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service
Six months of working in a virtual role where the supervisor is not physically in the same space
Six months of PBM/pharmaceutical related work strongly desired
Education:
- High School Diploma or GED required
- Bachelors degree in related field or equivalent work experience preferred
Skills:
- Call center, Prior authorization
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Atlanta, GA, United States US Tech Solutions, Inc. Full timeDuration: 06 Months Job Summary: • Training and working virtually • Utilizing multiple software systems to complete Medicare appeals case reviews • Meeting or exceeding government mandated timelines • Complying with turnaround time, productivity and quality standards • Conveying resolution to beneficiary or provider via direct communication...