Job Summary
A company is looking for a Specialist I, Prior Authorization.
Key Responsibilities
- Review, process, and troubleshoot incoming Prior Authorization requests for medications
- Communicate prior authorization criteria to providers and assist them in submitting requests
- Maintain compliance with regulatory guidelines and departmental performance metrics
Required Qualifications, Training, and Education
- High school degree or equivalent; post high school education such as L.P.N. or Certified Pharmacy Technician is desired
- Previous customer service experience is required
- Previous data entry experience is preferred
- Experience in health insurance/pharmacy insurance or managed care organization is preferred
- Prior authorization processing experience is desired
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