Job Title: Prior Authorization Specialist
Responsibilities:
- Support the initiation of new prior authorization requests for patients.
- Determine the appropriate prior authorization form based on the patient's insurance provider.
- Collaborate with prescribers and medical offices to accurately complete prior authorization forms.
- Follow up with medical offices to monitor the status of prior authorization requests.
- Communicate updates regarding prior authorizations to patients and providers.
- Work with medical offices to manage appeals related to prior authorizations.
- Address inquiries from internal departments concerning prior authorization processes.
Requirements:
- High school diploma or GED required; a Bachelor’s degree is strongly preferred.
- Experience in customer service or within an inbound call center is essential.
- Excellent verbal and written communication skills.
- Proficient technical skills, strong analytical abilities, keen attention to detail, sound judgment, and a focus on operations.
- Commitment to delivering exceptional patient care.
- Ability to collaborate effectively within a team and across departments.
Preferred Qualifications:
- At least one year of experience with prior authorizations or insurance verification in a pharmacy setting.
- Familiarity with pharmacy benefits and claims processes.
Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances)
Health Benefits / Dental / Vision (Medix Offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).)
401k (eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1)
Short Term Disability Insurance
Term Life Insurance Plan
