Prescription Prior Authorization Specialist

Job Description:

• Utilize and comprehend eClinicalWorks, including telephone encounters, chart notes, and provider directives
• Verify insurance coverage and prescription formularies to ensure prescription payment
• Submit prior authorizations to insurance companies via phone, fax, and electronic systems
• Answer incoming calls and address patient concerns and questions regarding authorization status and process
• Maintain accurate documentation of authorizations and prior approvals
• Work directly with insurance companies, pharmacies, and providers to resolve authorization issues
• Monitor and track established patient prescription authorizations
• Work closely with providers, Ideal Option staff, and pharmacies to ensure the best patient care
• Represent Ideal Option professionally and with a positive attitude
• Comply with national PHI laws including HIPAA and 42 CFR Part 2
• Perform other duties as assigned by supervisor

Requirements:

• High School Diploma or GED
• Experience with personal computers (word processing and/or electronic spreadsheets)
• Preferably one year or more of experience in office work
• Effective verbal and written communication skills
• Proficiency in Excel
• Ability to multitask, learn quickly, and work in a fast-paced environment
• Knowledge of chemical dependency and its effects on individuals, families, and communities is required
• Compliance with national PHI laws including HIPAA and 42 CFR Part 2
• Continual sustained attendance

Benefits:

• Medical, vision, and dental
• Short-term and long-term disability options
• Life insurance
• Employee Assistance and Life Assistance programs
• A 401K retirement program
• Pet Insurance
• Paid time off and paid holidays