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Prior Authorization Specialist - Appleton, WI
Do you have a background in medicine or medical insurance? Do you pride yourself on your customer service skills? Looking to grow with a company that values their employees and proves it by offering competitive pay, advancement opportunities, and great benefits? If so, then Pro Staff has a FANTASTIC opportunity for you with a growing health solutions company right here in Appleton!
We are seeking experienced customer service representatives with a strong understanding of health insurance and experience processing authorization to come on board as a Prior Authorization Specialist. In this role, you will review, process, and troubleshoot incoming prior authorization requests for various medications according to regulatory and client requirements. You will work within a team to meet performance goals and maintain compliance, and work with clinical departments to ensure requests are processed in an accurate and timely manner.
This role is a great opportunity to gain experience in understanding formularies, clinical programs, regulatory guidance, and other pharmacy benefit components. You will grow in your understanding of general benefit management and health care industry language and practices.
Other duties include:
- Researching electronic and manual claims and troubleshooting any issues
- Communicating prior authorization criteria to providers
- Assist providers in submitting requests, providing formulary product information, and providing updates regarding request statuses
- Develop and utilize knowledge of Medicare D, Medicaid, and other programs
- Participate in team learning and operations
- Protect information according to HIPAA regulations
- Utilize opportunities for personal and professional development as offered through the company and continually review new resources used in prior authorization processing
Compensation: $14.25 per hour
Hours: 10:30AM-6:30PM or later, some weekends and holidays
- Minimum High School diploma or equivalent
- L.P.N., Certified Pharmacy Technician, Medical Terminology, or Medical Transcription training desired
- Strong customer skills and phone etiquette
- Attention to detail and computer proficiency, including basic knowledge of Microsoft Office and internet
- Strong analytical, research, and problem-solving capabilities
- Health insurance/pharmacy insurance or managed care organization experience preferred
- Current pharmacy technician certification or ability to become certified required
- Experience with Medicare and/or Medicaid regulatory guidance preferred
Do you have the experience or drive to thrive in this role? Looking for next steps to grow in your career? Apply today while spots are available! Please send resumes to firstname.lastname@example.org or visit prostaff.com to apply.
EQUAL OPPORTUNITY EMPLOYER
Atterro supports affirmative action and equal employment opportunity. Atterro will provide equal employment in employment practices to all associates and applicants for employment. Employment decisions shall be made without regard to any protected characteristic such as, but not limited to, race, color, religion, gender, age, disability, national origin, ancestry, gender identity, sexual orientation, marital status, status in regard to public assistance, disabled veterans, recently separated veterans, Armed Forces service medal veterans and other protected veterans, genetic information and other legally protected classes. Furthermore, Atterro is an E-Verify employer. Information provided on this application will not be used for any discriminatory purposes. Atterro complies with all applicable federal, state and local non-discrimination laws and regulations. Atterro will provide reasonable accommodations in the application or interviewing process. If you need a reasonable accommodation in the application or interviewing process, please contact us.
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Appleton, WI 54914
United States of America
Light Industrial / LI - Manufacturing
Temp to Hire Position
Folder Group ID:234
Apply for this Position
Job Title: Prior Authorization Specialist
Location: Appleton, WI 54914
Job Type: Temp to Hire Position
Reference ID: 276980
Posted Date: 3/20/2017