About the job
The Prior Authorization Specialist plays a pivotal role in facilitating patient access to necessary medications and treatments. This full-time position operates Monday through Friday from 11 AM to 8 PM, and offers a competitive hourly wage between $16 and $19. Ideal candidates should possess a minimum of 1-2 years of experience in insurance verification and a comprehensive understanding of the full prior authorization process, including obtaining and completing forms, liaising with healthcare providers, and acquiring relevant medical documentation.
Key Responsibilities:
- Engage with patients to gather essential information for processing prescriptions, refills, and co-pay card applications, fostering strong and lasting relationships.
- Conduct thorough investigations and verifications of benefits for pharmacy and medical claims, collaborating with financial assistance teams as needed.
- Manage the prior authorization process by initiating requests, providing additional information, tracking progress, and maintaining communication with customers throughout.
- Oversee the appeals process by coordinating communication between patients, physicians, and insurance companies, drafting clinical appeal letters based on specific denial reasons.
- Regularly check the status of prior authorizations and appeals with insurance companies, ensuring timely updates for all parties involved.
