Medical Authorization and Appeals Representative

Pharmacy Technician
May 7, 2021
Pharmacy Technician
May 24, 2021

Medical Authorization and Appeals Representative

  • Florida
  • Pennsylvania
  • Texas
  • Ohio
  • Arizona
  • Illinois
  • Applications have closed
Job Description

• Receive inbound phone calls from our members and prescribers
• Complete Medicare appeals case reviews
• Meeting or exceeding government mandated timelines
• Complying with turnaround time, productivity and quality standards
• Conveying resolution to beneficiary or provider via direct communication and professional correspondence
• Acquiring and maintaining basic knowledge of relevant and changing Med D guidance

Required Qualifications:
• Working independently but ability to ask for assistance when needed
• Be technically capable to understand trouble-shooting steps and be able to communicate the results to leaders or IT
• Ability to effectively communicate verbally with members and prescribers while managing multiple software systems
• Ability to effectively plan, prioritize, and organize time and workload
• Ability to execute successfully in a deadline-oriented, fast-paced, highly-regulated environment
• Proficient in navigation of multiple computer applications
• Proficient use of keyboard, mouse and ability to navigate 2 workstation monitors
• Ability to type more than 30 WPM

Preferred Qualifications:
• At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service
• Six months of working in a virtual role where the supervisor is not physically in the same space
• Six months of PBM/pharmaceutical related work strongly desired

Must be flexible to work an 8 hour shift between the hours of 7:00 am – 8:00 pm, Monday – Friday. Training will be 8:00 am – 4:30 pm CST.

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.