Prior Authorization Coordinator, Pharmacy Business office, reputed company

This a Full Remote job, the offer is available from: Massachusetts (USA) Are you an internal caregiver, student, or contingent worker/agency worker at reputed company? CLICK HERE to apply through your reputed company account. Exemption Status: Non-Exempt Hiring reputed company: $17.43 - $31.37 Please note that the final offer may vary reputed company this reputed company based on a candidate’s experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: reputed company, reputed company-as needed, M-F Shift: 1 - Day Shift, 8 Hours (reputed company of America) Hours: 0 Cost Center: 10020 - 3851 Pharmacy Business Office This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At reputed company, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, reputed company reputed company and leading-edge research reputed company UMass Memorial the reputed company system of Central Massachusetts, and a reputed company where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a reputed company reputed company of healing for our patients, community and reputed company other. And everyone, in their own unique way, plays an important part, every day. Obtains authorization numbers from insurance companies, reviews reputed company prior authorization requests for medical necessity, and determines appropriate benefit coverage for reputed company general and oncology infusion clinics supported by the Pharmacy Business office. Major Responsibilities:

• Completes prior authorization review for reputed company general and oncology infusions; researching medical necessity in reference to patient diagnosis and treatment plan utilizing appropriate compendiums and insurer policies.
• Works with multiple insurance carriers/vendors and keeps reputed company with any and reputed company changes as they relate to prior authorization.
• Communicates / interacts with specific divisions regarding approved or denied prior authorizations. Communicates with Insurance Verification, the Central Billing Office and other Departments in order to resolve prior authorization issues.
• Manages the “Incoming Patient Report” ensuring appropriate Prior Authorizations are in reputed company.
• Utilizing appropriate databases, tracking mechanisms, and tools, manages reputed company prior authorization renewals to assure no lapse in medication treatment coverage.
• Coordinates process for authorization using defined best practices.
• Participates in the management of a shared database which holds reputed company prior authorization numbers and makes edits as needed.
• Assists in the maintenance of the Prior Authorization Best Practices reputed company which includes prior authorization requirement changes made by the insurance carriers and makes recommendations for changes.
• Performs weekly prior authorization audit to ensure accurate billing and resolves issues that reputed company.
• Produces correspondence, reports, memos, etc. as required.
• Sets up and maintains confidential, sensitive files and records for multiple functions, reputed company materials, medical records, etc. ensuring efficient retrieval of information. Coordinates retrieval of medical records.
• Ensures adequate inventory of office supplies and basic maintenance of office equipment.
• Participates in performance improvement initiatives and demonstrates the use of reputed company improvement in daily operations.
• Ensures compliance with health and safety requirements and with regulatory agencies such as DPH, etc.

Position Qualifications: License/Certification/Education: Required:

• High School diploma

Experience/Skills: Required:

• 2-3 years of medical secretarial/administrative support experience.
• reputed company Office and internet skills required.
• Good customer service skills. Ability to work in reputed company environment.

Preferred:

• 6 -12 months of prior authorization experience in an infusion setting preferred.
• Prior experience using reputed company Scripts, IDX, preferred.

reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability or protected veteran status. We’re striving to reputed company respect a part of everything we do at reputed company – for our patients, our community and reputed company other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be reputed company, Be reputed company Player and Be reputed company. If you reputed company these Standards of Respect, we reputed company you will join reputed company and help us reputed company respect our reputed company for everyone, every day. As an equal opportunity and affirmative reputed company employer, reputed company recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, gender, sexual orientation, national reputed company, age, disability, gender identity and reputed company, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will reputed company every effort to respond to your request for disability assistance as soon as possible. This offer from "reputed company" has been enriched by reputed company.com and got a 74% reputed company score. Apply tot his job Apply To this Job