Prior Authorization Specialist

1 month ago


Boise, Idaho, United States Medix™ Full time
Prior Authorization Specialist Job Description

Medix is seeking a skilled Prior Authorization Specialist to support our team in Boise. As a Prior Authorization Specialist, you will play a critical role in ensuring seamless patient care by facilitating prior authorization requests.

Key Responsibilities:
  • Initiate new prior authorization requests for patients and collaborate with prescribers and medical offices to accurately complete forms.
  • Determine the appropriate prior authorization form based on the patient's insurance provider and follow up to monitor the status of requests.
  • Communicate updates regarding prior authorizations to patients and providers, ensuring timely and effective resolution.
  • Work with medical offices to manage appeals related to prior authorizations and address inquiries from internal departments concerning prior authorization processes.
Requirements:
  • High school diploma or GED required; a Bachelor's degree is strongly preferred.
  • Experience in customer service or within an inbound call center is essential.
  • Excellent verbal and written communication skills, with proficiency in technical skills, analytical abilities, attention to detail, sound judgment, and a focus on operations.
  • Commitment to delivering exceptional patient care and ability to collaborate effectively within a team and across departments.
  • Flexibility to work shifts between 8 AM and 8 PM.
Preferred Qualifications:
  • At least one year of experience with prior authorizations or insurance verification in a pharmacy setting.
  • Familiarity with pharmacy benefits and claims processes.

Medix offers a comprehensive benefits package, including paid sick leave, health benefits, dental, vision, 401k, short-term disability insurance, and term life insurance plan.


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