Prescription Prior Authorization Specialist

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $18 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Exceptional HR Solutions, LLC

WebsiteLinkedInAll Job Openings

11 - 50 employees

💼 Consulting

👥 HR Tech

🤝 B2B

Consulting • HR Tech • B2B

Exceptional HR Solutions, LLC is an advising, consulting, and executive coaching company that supports leaders and organizations with their human resources needs. The company specializes in various areas of HR, including consulting, strategy, payroll management, recruiting, and HR systems implementation, providing fractional HR services to enhance the people aspect of businesses.

📋 Description

• Utilize and comprehend eClinicalWorks, including telephone encounters, chart notes, and provider directives • Verify insurance coverage and prescription formularies to ensure prescription payment • Submit prior authorizations to insurance companies via phone, fax, and electronic systems • Answer incoming calls and address patient concerns and questions regarding authorization status and process • Maintain accurate documentation of authorizations and prior approvals • Work directly with insurance companies, pharmacies, and providers to resolve authorization issues • Monitor and track established patient prescription authorizations • Work closely with providers, Ideal Option staff, and pharmacies to ensure the best patient care • Represent Ideal Option professionally and with a positive attitude • Comply with national PHI laws including HIPAA and 42 CFR Part 2 • Perform other duties as assigned by supervisor

🎯 Requirements

• High School Diploma or GED • Experience with personal computers (word processing and/or electronic spreadsheets) • Preferably one year or more of experience in office work • Effective verbal and written communication skills • Proficiency in Excel • Ability to multitask, learn quickly, and work in a fast-paced environment • Knowledge of chemical dependency and its effects on individuals, families, and communities is required • Compliance with national PHI laws including HIPAA and 42 CFR Part 2 • Continual sustained attendance

🏖️ Benefits

• Medical, vision, and dental • Short-term and long-term disability options • Life insurance • Employee Assistance and Life Assistance programs • A 401K retirement program • Pet Insurance • Paid time off and paid holidays