Prior Authorization Representative GA

5 days ago


Atlanta, United States US Tech Solutions Full time

Duration: 06 Months Learn more about the general tasks related to this opportunity below, as well as required skills. 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 Bachelor’s degree in related field or equivalent work experience preferred Skills: Call center, Prior authorization



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