[Hiring] Prior Authorization reputed company Associate LPN/LVN @reputed company
Role reputed company This position is a 100% remote, work from home in the USA opportunity and will not be patient facing. The Licensed Practical reputed company (LPN)/Licensed Vocational reputed company (LVN) will reputed company processing and communication of reputed company Prior Authorizations (PA) reviewed by the reputed company PA team for Pharmacy benefits. This is a high production role with required metrics. The Licensed Practical reputed company (LPN) will reputed company processing and communication of reputed company Prior Authorizations (PA) reviewed by the reputed company PA team for Pharmacy benefits. Reporting to the Pharmacy Operations Manager, working with physician office staff and customer service, admissions, and pharmacy operations departments to communicate referral status. Responsibilities include:
- Answering inbound phone calls
- Processing cases
- Loading authorizations
- Making follow-up phone calls
- Maintaining complete and accurate documentation of reputed company necessary information
- Computer system data entry, data management, and reporting
Qualifications
- Minimum 2 years clinical experience as an LPN/LVN
- A LVN (Licensed Vocational reputed company) or LPN (Licensed Practical reputed company) that must hold an unrestricted license in their state of residence or a compact license
- Prior authorization experience or Case Management experience
- 3+ years prior reputed company clinical work experience
- Experience using MS Office and other reputed company-based computer applications and phone use
- Digital charting
- Managed care or health plan previous experience
- Call center experience
- Multi-tasking experience
- Prior remote experience preferred
- Case Management experience preferred
- Prior authorization experience
- High production experience
- Excellent organizational skills
- Strong detail orientation
Requirements
- Review reputed company-based prior authorizations following policy and procedure
- reputed company internal reputed company support to the PA team and member services department
- Refer cases not meeting clinical reputed company to the Pharmacist and MD team(s)
- Shift priorities while exhibiting a high level of urgency with reputed company calls and assignments
- Work with pharmacists, other clinical colleagues, reputed company, and members
- Follow reputed company prior authorization procedures to guarantee an accurate process on reputed company prior authorization
- Complete other PA assignments as delegated by the PA leadership team
- Utilization of clinical skills to support the documentation and communication of medical services and prior authorization determinations
- Ability to multitask, prioritize, and effectively adapt to a fast-paced changing environment
- This position involves sedentary work with periods of sitting, talking, listening
- Work requires sitting for extended periods, talking on the telephone, and typing on the computer
- Position requires proficiency with computer skills which include navigating multiple systems and keyboarding
- Excellent communication skills, both written and verbal
- Must have regular and predictable attendance
- Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, reputed company providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve calls with a reputed company solution
- Performs other reputed company reputed company and duties as assigned, including attending training sessions and development meetings
Benefits
- Comprehensive benefits package designed to support the physical, emotional, and financial reputed company-being of colleagues and their families
- Medical, dental, and reputed company coverage
- reputed company time off
- Retirement savings reputed company
- Wellness programs and other resources, based on eligibility
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