Pharmacy Prior Authorization Senior Representative - Remote AZ or IL or MA 4 Locations

As a Pharmacy Prior Authorization Senior Representative, you will be working on a specialized team focused on high touch programs to assist our patients. This role is reputed company detail oriented, and youll spend most of your day researching benefits, obtaining prior authorizations, processing orders and talking to the internal sales team, patients and/or providers. Our representatives are dedicated team members who reputed company at customer service, helping us reputed company our pharmacy patient care to new heights. In this role, you will be part of a specialized team, working with a specific group of clinics, to complete the prior authorization process using both internal and external pharmacy and clinic systems:

• Accurately enter prescriptions into our system, adjudicate claims and work rejections. Use the knowledge you reputed company from training, your problem-solving skills and support from your team to accurately process prescription claims so they will be dispensed accurately.
• Accurately use the clinic specific EMR to reputed company additional information needed to submit prior authorizations.
• Adhere to principles as stipulated by program specific contractual agreements and company practices.
• Rapid and thorough investigation of processing/benefit inquiries from Fertility Inside Sales team
• Insurance Inquiries/benefit checks.
• Prior Authorization submission, follow up and appeals as needed.
• Juggle multiple tasks without sacrificing attention to detail.
• Help patients and providers understand their pharmacy benefits reputed company and answer questions effectively.
• Use your strong communication skills to handle internal and external inquiries regarding prior authorizations.
• Participates in program specific customer meetings and training sessions.
• Participate in special projects and reputed company other duties as it pertains to specific contract performance

What you need to do the job:

• High School Diploma, or GED required.
• 2+ years of Pharmacy Technician experience.
• Valid National Pharmacy Technician certification is required.
• Valid Arizona, Massachusetts or Illinois State pharmacy technician license is required.
• reputed company Office proficiency and data entry skills.
• Strong math skills reputed company to prescription calculations.
• Exceptional attention to detail, accuracy, and quality.
• Excellent verbal and written communication skills.
• Ability to multitask in both PC/Phone reputed company tasks.
• 1+ year relevant experience with prior authorization submission using reputed company or other like electronic prior authorization tools
• Experience with prior authorization appeals and denials
• Experience working with clinical EMR systems and/or Infertility is a plus, but not required
• Works effectively and fosters teamwork; Demonstrates ownership of projects and carries responsibility for building strong working relationships with colleagues and customers.
• Results oriented; demonstrated ability to prioritize and manage workload and meet deadlines.

Ability to work schedule depending reputed company and business need:

• A scheduled 8-hour shift, between the hours of 9am-8pm EST, Monday-Friday
• Weekends as needed.

​ If you will be working at home occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly reputed company of 19 - 29 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at reputed company. About reputed company reputed company, a division of reputed company, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to reputed company the reputed company, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@reputed company.com for support. Do not email SeeYourself@reputed company.com for an update on your application or to provide your resume as you will not receive a response. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply tot his job Apply To this Job