Prior Authorization Specialist

9 hours ago


Chesterfield, Missouri, United States Medix™ Full time
Prior Authorization Specialist Job Description

Medix is seeking a skilled Prior Authorization Specialist to support our team in ensuring seamless patient care.

Key Responsibilities:

  • Initiate new prior authorization requests for patients and collaborate with prescribers and medical offices to complete forms accurately.
  • 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, and work with medical offices to manage appeals related to prior authorizations.
  • Address inquiries from internal departments concerning prior authorization processes and provide exceptional patient care.

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, proficient technical skills, and a focus on operations.
  • Commitment to delivering exceptional patient care and ability to collaborate effectively within a team and across departments.

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.

Benefits:

  • Paid Sick Leave according to state and local sick leave ordinances.
  • Health Benefits, Dental, Vision, 401k, Short Term Disability Insurance, and Term Life Insurance Plan.


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