Pharmacy Prior Authorization Representative

Responsibilities:

• Assist in the initiation of new prior authorization requests to providers


• Identify the correct prior authorization form required for the patient’s insurance provider


• Coordinate with prescribers and medical offices to ensure applicable information is translated onto prior authorization forms


• Follow up with medical offices to check the status of prior authorization requests


• Assist with communicating the status of prior authorizations to both patients and providers


• Coordinate with medical offices to handle Appeals


• Respond to internal questions from other departments related to prior authorization requests

Requirements:

• High school diploma or GED required, Bachelor’s degree strongly preferred


• Customer service or inbound call center experience required


• Strong verbal and written communication skills


• Sound technical skills, analytical ability, attention to detail, good judgment, and strong operational focus


• A passion for providing top-notch patient care


• Ability to work with peers in a team effort and cross-functionally

Preferred Qualifications:

• 1+ year(s) working with prior authorizations or insurance verification in a pharmacy


• Knowledge of pharmacy benefits and pharmacy claims