Responsible for downloading PA requests and entering into CoverMyMeds
Track all other appropriate patient and pharmaceutical information with the goal of accurate information
Will be responsible for resulting out the PA, documenting, and following up on all open PA’s not escalated to management
Communicate with providers and office staff through email and phone calls regarding any issue with the PA process and/or individual patients, such as incomplete information, answering status questions, denials etc.
Call pharmacy, patient, and insurances when needed in order to successfully complete PA’s
Determine which PA’s require escalation or further assistance from management
Required Qualifications
Must complete all necessary training for EHR systems in EPIC
Must possess a working knowledge of pharmacy processes.
High school diploma or Associates Degree in Science in combination with 2-3 years’ experience working with health insurance or in a healthcare setting is essential.
Outstanding customer service, written and verbal communication skills.
Ability to prioritize and handle multiple tasks, producing high-quality work in a timely, accurate and efficient manner is required.
Proficiency in the use of computers and basic software applications is necessary.
Ability to be flexible and work within a team-focused, participative management framework is required
Prior Medication authorization experience is preferred.The Medication Prior Authorization Specialist is responsible for obtaining all medication prior authorizations.
Responsible for downloading PA requests and entering into CoverMyMeds
Track all other appropriate patient and pharmaceutical information with the goal of accurate information
Will be responsible for resulting out the PA, documenting, and following up on all open PA’s not escalated to management
Communicate with providers and office staff through email and phone calls regarding any issue with the PA process and/or individual patients, such as incomplete information, answering status questions, denials etc.
Call pharmacy, patient, and insurances when needed in order to successfully complete PA’s
Determine which PA’s require escalation or further assistance from management
Required Qualifications
Must complete all necessary training for EHR systems in EPIC
Must possess a working knowledge of pharmacy processes.
High school diploma or Associates Degree in Science in combination with 2-3 years’ experience working with health insurance or in a healthcare setting is essential.
Outstanding customer service, written and verbal communication skills.
Ability to prioritize and handle multiple tasks, producing high-quality work in a timely, accurate and efficient manner is required.
Proficiency in the use of computers and basic software applications is necessary.
Ability to be flexible and work within a team-focused, participative management framework is required
Prior Medication authorization experience is preferred.
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