01Overview
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Role Description
As a
Prescription Prior Authorization Specialist
, you play a key role in ensuring our patients' prescriptions will be covered by their insurance. We submit prior authorizations as needed to enable patients to pick up the correct prescription in a timely and cost-effective manner. Additional responsibilities include:
Utilizes and comprehends eClinicalWorks, including telephone encounters, chart notes, and provider directives.
Ensures payment of prescriptions by verifying insurance coverage and prescription formularies.
Submits prior authorizations to insurance companies via phone, fax, and electronic systems.
Answers incoming calls and addresses patients' concerns and/or questions regarding their authorization process.
Maintains accurate documentation of authorizations.
Works directly with insurance companies, pharmacies, and providers.
Monitors and tracks established patient prescription authorizations.
Processes incoming calls and addresses patient concerns and/or questions regarding their authorization status.
Works directly with insurance companies and pharmacies on resolving authorization issues.
Maintains accurate documentation of prior approvals.
Works closely with providers, Ideal Option staff, and pharmacies to ensure the best patient care.
Represents Ideal Option professionally and with a positive attitude.
Complies with national PHI laws including HIPAA and 42 CFR Part 2.
Maintains continual sustained attendance.
Other duties as assigned by supervisor.
Qualifications
Effective verbal and written communication skills.
Proficient in Excel.
Ability to multitask and learn quickly in a fast-paced environment.
Knowledge of chemical dependency and its effects on individuals, families, and communities is required.
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.
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.
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Company : IO Management Company LLC
Salary : Full-time .
