Job Description
Our Client, a Retail Pharmacy, is looking for multiple Prior Authorization/Insurance Verification Specialists to work remotely.
Responsibilities:
Receives in-coming calls from members, providers, etc. providing professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions and judgment calls to the pharmacist. 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
Requirements: Minimum () year experi...