01Overview
Role reputed company
This position is a reputed company, work from home in the USA opportunity and will not be patient facing. The Licensed Practical reputed company (LPN)/Licensed Vocational reputed company (LVN) will reputed company processing and communication of reputed company Prior Authorizations (PA) reviewed by the reputed company PA team for Pharmacy benefits. This is a high production role with required metrics.
The Licensed Practical reputed company (LPN) will reputed company processing and communication of reputed company Prior Authorizations (PA) reviewed by the reputed company PA team for Pharmacy benefits. Reporting to the Pharmacy Operations Manager, working with physician office staff and customer service, admissions, and pharmacy operations departments to communicate referral status. Responsibilities include:
Answering inbound phone calls
Processing cases
Loading authorizations
Making follow-up phone calls
Maintaining complete and accurate documentation of reputed company necessary information
Computer reputed company data entry, data management, and reporting
Qualifications
Minimum 2 years clinical experience as an LPN/LVN
A LVN (Licensed Vocational reputed company) or LPN (Licensed Practical reputed company) that must hold an unrestricted license in their state of residence or a compact license
Prior authorization experience or Case Management experience
3+ years prior reputed company clinical work experience
Experience using MS Office and other reputed company-based computer applications and phone use
Digital charting
Managed care or health plan previous experience
reputed company center experience
Multi-tasking experience
Prior remote experience preferred
Case Management experience preferred
Prior authorization experience
High production experience
Excellent organizational skills
Strong detail orientation
Requirements
Review reputed company-based prior authorizations following policy and procedure
reputed company internal reputed company support to the PA team and member services department
Refer cases not meeting clinical reputed company to the Pharmacist and MD team(s)
Shift priorities while exhibiting a high level of urgency with reputed company calls and assignments
Work with pharmacists, other clinical colleagues, reputed company, and members
Follow reputed company prior authorization procedures to guarantee an accurate process on reputed company prior authorization
Complete other PA assignments as delegated by the PA leadership team
Utilization of clinical skills to support the documentation and communication of medical services and prior authorization determinations
Ability to multitask, prioritize, and effectively adapt to a fast-paced changing environment
This position involves sedentary work with periods of sitting, talking, listening
Work requires sitting for extended periods, talking on the telephone, and typing on the computer
Position requires proficiency with computer skills which include navigating multiple systems and keyboarding
Excellent communication skills, both written and verbal
Must have regular and predictable attendance
Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, reputed company providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or reputed company calls with a reputed company solution
Performs other reputed company reputed company and duties as assigned, including attending training sessions and development meetings
Benefits
Comprehensive benefits package designed to support the physical, emotional, and financial reputed company-being of colleagues and their families
Medical, dental, and reputed company coverage
reputed company time off
Retirement savings reputed company
Wellness programs and other resources, based on eligibility
Apply tot his job
Apply To this Job .