Prior Authorization Representative

Pharmacy Technician
May 4, 2021
Warehouse Associate
May 5, 2021

Prior Authorization Representative

Job Description:

  • This position focuses on completing criteria based prior authorizations for Specialty medications.
  • Maintains complete, timely, and accurate documentation of all approvals and denials and transfers all clinical questions and judgment calls to the pharmacist.
  • May take inbound customer service calls during periods of high volume in order to assist our call center sites.
  • Make outbound calls to providers and members to collect additional information needed to process prior authorizations if necessary.
  • Manage case load of for all clients by researching and triaging incoming fax requests.
  • Use adjudication systems to identify the type of request and create, route, and/or complete appeals or requests in accordance with department processes.
  • Process external review appeal requests.

This is temporarily a work from home position. Must be able to support a remote work environment.

Must be flexible to work an 8 hour shift between the hours of 9:00 am – 8:00 pm, Monday – Friday **Training hours may vary.

Pay rate is $14.95/hr.

Our Mission:

Choice One Staffing Group offers our employees assistance in finding the best positions for their skills, talents, and experience. It’s simple.  At Choice One Staffing Group, People are our PURPOSE and YOUR success is OUR success!

Try us!  You’ll find we focus on providing a positive candidate experience from your first contact through the completion of your first assignment and every assignment.

Employee Benefits:

We offer medical, holiday pay, vacation pay, referral bonuses and pre-employment preparation.

Specialized Staffing:

We specialize in Administrative, Light Industrial, Technical, Medical and Hospitality

EEO Policy:

Choice One Staffing Group, Inc. is an equal opportunity employer that prohibits employment discrimination based on race, color, religion, sex, national origin and ancestry, individuals who are 40 years of age and older or qualified individuals with disabilities.

To apply for this job please visit www.applyonline.bz.