A Health Care Start-up is seeking a Prior Authorization Specialist based in NYC.
Worksite Setting: On-site office, but may switch to remote/hybrid down the road.
Worksite location(s): SoHo NYC
Schedule: Full time day flexible, minimum 20 hrs/week (weekdays only)
JOB Description:
Start Date: Immediate
Key Responsibilities
* Complete prior authorization requests based on clinical documentation for prescription medications via ePA, fax, and phone
* Contact insurance companies to verify patient benefits and coverage details
* Review clinical information and ensure all required documentation is included with submissions
* Document and escalate any issues related to prior authorization requests (e.g., need for additional information or documentation from providers)
* Serve as a liaison between patients, healthcare providers, and insurance companies
Qualifications
* High school diploma or equivalent required; Bachelor's degree preferred
* 1+ years of experience in a healthcare operations / administration role that includes prior authorization work (e.g. medical assistant, pharmacy technician, nurse)
* Familiarity with EHR systems
* Strong understanding of medical terminology (especially pharmaceutical) and insurance process
* Attention to detail and strong organizational skills
* Excellent communication skills and adept at using web-based tools/systems
* Ability to work in person in Soho, NYC
