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Customer Service Representative

2 months ago

San Francisco, California, United States Hire Talent Full time

Job Summary

The Prior Authorization Representative is a key member of the Hire Talent team, responsible for ensuring seamless patient access to various therapies. This role requires strong communication and problem-solving skills to facilitate collaboration with physician offices and payers.

Key Responsibilities

  • Validate patient insurance coverage and communicate any issues with benefits or coverage to the appropriate managers.
  • Verify prior authorization requirements and obtain authorization when necessary.
  • Coordinate required paperwork, clinical notes, and forms for submission to support requests.
  • Follow up frequently to ensure visibility on authorization status throughout the approval process.
  • Utilize knowledge of payer payment processes and prior authorization procedures to ensure efficient patient access.
  • Develop and maintain strong relationships with physicians, sales representatives, payer representatives, and other stakeholders.
  • Apply advanced Microsoft Excel skills to analyze data and optimize processes.
  • Stay up-to-date on industry developments and regulatory changes to ensure compliance and best practices.

Requirements

  • Basic knowledge of ICD9/10 and CPT codes, with expertise in a subset of client therapy codes.
  • Superior customer service skills, with outstanding communication and interpersonal skills.
  • Ability to learn and adapt to multiple CRM software programs.
  • Excellent organizational and time management skills, with the ability to handle multiple inquiries simultaneously.