Job Description
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. 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. Apply tot his job