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Prior Authorization Specialist
2 months ago
Job Title: Prior Authorization Specialist
About the Role:
We are seeking a highly skilled Prior Authorization Specialist to join our team at Tandym Group. As a Prior Authorization Specialist, you will play a critical role in ensuring that our clients receive the necessary medical treatments and services in a timely and efficient manner.
Key Responsibilities:
- Complete prior authorization requests based on clinical documentation for prescription medications via electronic prior authorization (ePA), fax, and phone.
- Contact insurance companies to verify patient benefits and coverage details.
- Review clinical information and ensure all required documentation is included with submissions.
- Document and escalate any issues related to prior authorization requests (e.g., need for additional information or documentation from providers).
- Serve as a liaison between patients, healthcare providers, and insurance companies.
Qualifications:
- High school diploma or equivalent required; Bachelor's degree preferred.
- 1+ years of experience in a healthcare operations/administration role that includes prior authorization work (e.g., medical assistant, pharmacy technician, nurse).
- Familiarity with electronic health record (EHR) systems.
- Strong understanding of medical terminology (especially pharmaceutical) and insurance process.
- Attention to detail and strong organizational skills.
- Excellent communication skills and adept at using web-based tools/systems.
What We Offer:
As a Prior Authorization Specialist at Tandym Group, you will have the opportunity to work with a dynamic team of healthcare professionals and contribute to the delivery of high-quality patient care. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.
