Clinical Authorization Specialist

7 days ago

Fairfield, United States Actalent Full time
Job DescriptionJob DescriptionClinical Authorization Specialist - IMMEDIATE NEED

*** 13 WEEK CONTRACT ***

Job Description

We are seeking a Clinical Authorization Specialist to join our client with a dynamic intake team

Responsibilities
  • Retrieve, count, pour, and weigh prescriptions per written instruction.
  • Pre-pack medicines, bottle, and label as requested by pharmacy staff.
  • Utilize prior authorization and insurance knowledge to support the intake team for the pharmacy.
  • Conduct benefits investigations and manage prior authorizations for patients.
  • Validate insurance information before medication shipments
  • Use computer systems and make phone calls to verify patient and insurance information.
  • Handle dozens of outbound calls, often with significant hold times.
  • Prepare and manage lists of patients, coordinating with insurance companies for multiple patients simultaneously.
  • Maintain patience and professionalism while on hold with insurance companies.
  • Develop daily lists of high-priority patients based on upcoming infusion dates, in coordination with the intake manager and pharmacy team.
  • Make general assignments for patient and payer coordination each day.
  • Ensure efficient use of time during phone calls, with an expected talking time of 25% during peak periods.
  • Potentially receive special assignments from the intake manager.
Essential Skills
  • Experience in prior authorization review.
  • Knowledge of insurance verification and benefits.
  • Understanding of medical terminology.
  • Patient care experience.
  • Pharmacy technician license or medical assistant certification.
  • Experience in healthcare, medical billing, and using Epic systems.
Additional Skills & Qualifications
  • Dedicated worker with reliable transportation.
  • Committed to schedule with no PTO requests during the contract period.
  • Kind personality and good customer service skills.
  • Patience and professionalism.
Work Environment
  • The position offers a unique closed-door environment, so there is no face-to-face interaction with patients.
  • The work shift is Monday to Friday from 9:00 AM to 5:30 PM with a 30-minute break each day.
  • Expect to work at least 8 hours a day during the first weeks of January due to high demand.
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 & Inclusion

At 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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