[Hiring] Prescription Prior Authorization Specialist @IO Management Company LLC

Role Description

As a

Prescription Prior Authorization Specialist

, you play a key role in ensuring our patients' prescriptions will be covered by their insurance. We submit prior authorizations as needed to enable patients to pick up the correct prescription in a timely and cost-effective manner. Additional responsibilities include:
• Utilizes and comprehends eClinicalWorks, including telephone encounters, chart notes, and provider directives.
• Ensures payment of prescriptions by verifying insurance coverage and prescription formularies.
• Submits prior authorizations to insurance companies via phone, fax, and electronic systems.
• Answers incoming calls and addresses patients' concerns and/or questions regarding their authorization process.
• Maintains accurate documentation of authorizations.
• Works directly with insurance companies, pharmacies, and providers.
• Monitors and tracks established patient prescription authorizations.
• Processes incoming calls and addresses patient concerns and/or questions regarding their authorization status.
• Works directly with insurance companies and pharmacies on resolving authorization issues.
• Maintains accurate documentation of prior approvals.
• Works closely with providers, Ideal Option staff, and pharmacies to ensure the best patient care.
• Represents Ideal Option professionally and with a positive attitude.
• Complies with national PHI laws including HIPAA and 42 CFR Part 2.
• Maintains continual sustained attendance.
• Other duties as assigned by supervisor.

Qualifications
• Effective verbal and written communication skills.
• Proficient in Excel.
• Ability to multitask, learn quickly, and work in a fast-paced environment.
• Knowledge of chemical dependency and its effects on individuals, families, and communities is required.

Requirements
• High School Diploma or GED.
• Experience with personal computers (word processing and/or electronic spreadsheets).
• Preferably one year or more of experience in office work.

Benefits
• Medical, vision, and dental.
• Short-term and long-term disability options.
• Life insurance.
• Employee Assistance and Life Assistance programs.
• A 401K retirement program.
• Pet Insurance.
• Paid time off and paid holidays.