Clinical Authorization Specialist

6 days ago


Oklahoma City, Oklahoma, United States National Health Care Solutions Full time

Job Summary:

We are seeking a highly skilled and detail-oriented Clinical Authorization Specialist to join our team at National Health Care Solutions. As a Clinical Authorization Specialist, you will play a critical role in ensuring the efficient and effective processing of prior authorizations for medications.

Key Responsibilities:

  • Approve, dismiss, or withdraw prior authorizations of medication according to guidelines defined by our clients.
  • Respond to incoming calls in a timely manner, assisting callers with questions regarding approval or denial of medications, and resolving issues.
  • Enter data into our PA database, correcting errors as needed.
  • Process requests for information (RFIs) for client accounts.
  • Monitor the PAL/Client database, notifying management of errors and/or problems.
  • Maintain compliance with all company policies and procedures.

Additional Responsibilities:

  • Perform related duties as assigned by your supervisor.

Requirements:

  • Current or recent licensed Certified Pharmacy Technician.
  • High school diploma or equivalent.
  • Customer service experience required.
  • Excellent communication skills, including active listening.
  • Service-oriented and able to resolve customer grievances.
  • Proficient computer skills with the ability to learn new software.

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