Medical Prior Authorization Representative

Position: Medical Prior Authorization Representative (Temp to hire)
Pay: $17.50 per Hour
Location: Fully Remote
Shifts: You will be assigned shifts within the hours of 7 AM – 8 PM CST, M-F. You will be scheduled for an 8-hour shift within these hours.

This is a temp to hire role and a good way to get your foot in the door with an industry leader. You will be handling inbound calls from providers, members, pharmacies, etc. through the criteria based prior authorization process as well has conducting outbound calls. You will be assisting with Medicare Appeals processing as well. Your resume must show Prior Authorization and/or appeals to be considered. You must be comfortable on the phone; this is a high call volume position. Experience with Medicare D preferred. 

Training Hours:

• 8-week training period
• Monday to Friday, 8 AM – 4:30 PM CST
• No time off allowed during training. Any vacations or time off must be discussed during the initial phone screen.

Responsibilities:

• Utilize multiple software systems to complete Medicare appeals case reviews
• Verifying insurance benefits
• Checking medication orders
• Convey resolution to beneficiaries or providers via direct communication and professional correspondence
• Process appeals
• Acquire and maintain basic knowledge of relevant and changing Med D guidance
• Meet or exceed government-mandated timelines
• Comply with turnaround time, productivity, and quality standards
• Ability to work in a fast paced environment

Requirements:

• High School Diploma or GED required
• Minimum of 1 year prior authorization and/or appeals experience (must be clearly listed on resume)
• Minimum of 1 year call center experience
• 6 months of prior remote experience strongly preferred
• Must be able to pass background and drug screen if selected for employment
• Must be organized and detail-oriented

Choice One Staffing Group offers medical, holiday pay, vacation pay, referral bonuses and pre-employment preparation. 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.