Opportunity to work with a well-known hospital for a possible temp-to-perm position!
Job Detail
Job Description
Responsibilities/Job Duties:
- Review prior authorization requests and units for medications requested under the medical benefit
- Assess provider-submitted clinical information for clinical appropriateness based on predetermined clinical criteria
- Telephonic/ fax/ mail notification to members and providers of authorization decisions
- Ensure prior authorization reviews are conducted in time frames set forth by CMS and/or NYSDOH
- Establish great rapport with Provider offices via telephonic communication
- Send Providers requests for information sheets
- Ensure that patient information is always shared appropriately maintaining confidentiality and compliance with federal/HIPAA regulations
- Additional duties as assigned
Qualifications:
- Pharmacy Technician in the state with a certificate in good standing
- Minimum of 1-year experience conducting prior authorization reviews
- Strong clinical background
- Strong written and verbal communication skills in English
- Demonstrated critical thinking and problem-solving skills
- Team player with a passion for learning and interest in growing skills in a dynamic environment with various opportunities
- Strong telephonic communication skills
- ShareAustin:
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