Insurance Authorization & Appeals Representative

Pharmacy Technician
September 12, 2021
Office Clerk
September 14, 2021

Insurance Authorization & Appeals Representative

  • Texas

Job Description 

  • Effectively manage work volume by handling inbound calls/fax requests utilizing appropriate courteous and professional behavior based upon established standards. Sort incoming faxes in compliance with departmental and client requirements.
  • Manage case load of for all clients by researching and triaging incoming fax requests. Use eligibility 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 according to federal, client, and state mandated guidelines.
  • Act as a subject matter expert and assists with Coordinator duties dependent upon business needs. Provides support/mentoring to Coordinator staff to solve case processing questions and issues.
  • Collaborate with Pharmacy Technicians, Pharmacists, and other internal partners for timely resolution of issues with case processing.
  • Works closely with internal partners to develop work instructions and promote process improvements.

**This is a remote position but must live in the state of Texas.

**Requires the ability to effectively support a work from home environment. Must have the ability to work in a HIPAA compliant work area away from distractions, and must have their own secure private internet services of at least 25mbps/3mbps in order to ensure sufficient speed to adequately perform work duties.

HOURS: Will be scheduled an 8 hour shift between the hours of 7:00 am – 8:00 pm CST. Training hours may vary.

Pay Rate: $14.99/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.

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