Clinical Authorization Specialist
10 hours ago
Job Title: Clinical Authorization Specialist
Job Description:
We are seeking a Clinical Authorization Specialist who will be responsible for:
- Retrieving, counting, pouring, and weighing prescriptions per written instruction.
- Pre-packing medicines, bottling, and labeling as requested by pharmacy staff.
- Utilizing prior authorization and insurance knowledge to support the intake team.
- Conducting benefits investigations and managing prior authorizations for patients.
- Validating insurance information before medication shipments, especially at the beginning of the year.
- Using computer systems and phone calls to verify patient and insurance information.
- Handling dozens of outbound calls, often with significant hold times.
- Preparing and managing lists of patients, coordinating with insurance companies for multiple patients simultaneously.
- Maintaining patience and professionalism while on hold with insurance companies.
- Developing daily lists of high-priority patients based on upcoming infusion dates, in coordination with the intake manager and pharmacy team.
- Performing general assignments for patient and payer coordination each day.
- Efficiently using time during phone calls, with an anticipated talking time of 25% during peak periods.
- Receiving special assignments from the intake manager.
Hard Skills:
- Pharmacy technician license OR medical assistant certification
- Prior authorization review experience
- Insurance knowledge and benefits
Soft Skills:
- Patience
- Professionalism
- Efficient time management
Work Site:
- This is a fully on-site position in Fairfield, New Jersey.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & InclusionAt Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
- Hiring diverse talent
- Maintaining an inclusive environment through persistent self-reflection
- Building a culture of care, engagement, and recognition with clear outcomes
- Ensuring growth opportunities for our people
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
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