US Tech Solutions, Inc. | Prior Authorization Representative GA | atlanta, ga
2 weeks ago
Duration: 06 Months
Job Summary:
• Training and working virtually
• Utilizing multiple software systems to complete Medicare appeals case reviews
• Meeting or exceeding government mandated timelines
• Complying with turnaround time, productivity and quality standards
• Conveying resolution to beneficiary or provider via direct communication and professional correspondence
• Acquiring and maintaining basic knowledge of relevant and changing Med D guidance
Responsibilities:
• Working independently but be self-aware enough to know when to ask for help
• Be technically capable to understand trouble-shooting steps and be able to communicate the results to leaders or IT
• Ability to effectively communicate verbally with members and prescribers while managing multiple software systems
• Accountable and results driven
• Critical thinker/problem solver
• Receptive to constructive feedback and flexible in adapting to change
• Ability to effectively plan, prioritize, and organize time and workload
Experience:
• At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service
• Six months of working in a virtual role where the supervisor is not physically in the same space
• Six months of PBM/pharmaceutical related work strongly desired
Education:
- High School Diploma or GED required
- Bachelor’s degree in related field or equivalent work experience preferred
Skills:
- Call center, Prior authorization
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