Medication Authorization Specialist - Conway Regional Heath System
Conway, AR 72034
About the Job
Overview:
Ensures efficient initiation and follow-up of prior authorizations for various medications. Coordinates with clinic staff, insurance carriers, patients, pharmacy, and providers to accurately complete required documentation for insurance verification and approval in a timely manner.
Qualifications:
High school diploma or equivalent required. Previous experience in medical billing or prior authorization is highly preferred.
- Must be highly motivated and able to work independently with minimal direct supervision
- Able to communicate effectively with pharmacists, nurses, and other healthcare workers in a mature, approachable, professional, and comfortable manner both in-person and on the phone
- Excellent organizational and time management skills to prioritize multiple tasks efficiently
- Strong attention to detail
- Able to learn required computer skills
- Able to train other personnel
- Initiate, review, and process prior authorization requests and reapprovals for medications
- Verify insurance coverage and eligibility for requested medications
- Request and collect necessary documentation from healthcare provider offices, ensuring all required information is complete and accurate for prior authorization submissions
- Communicate with healthcare providers, insurance companies, and patients regarding authorization status and requirements
- Monitor the progress of prior authorizations and diligently follow up with insurance providers and healthcare professionals to expedite approval processes
- Maintain professional and effective communication with healthcare provider offices to obtain additional information, clarify details, and ensure a smooth prior authorization process
- Provide exceptional customer service to patients, healthcare providers, and internal team members, addressing inquiries and concerns promptly and courteously
- Assist in initiating appeals when necessary and follow up on appeals to ensure timely resolution
- Demonstrate the ability to multitask efficiently in a fast-paced environment, managing multiple prior authorizations simultaneously
- Maintain confidentiality and adhere to HIPAA regulations when handling sensitive patient information
- Clearly document progress on each prior authorization and all communications and contacts with providers and personnel
- Assists in performance improvement activities
- Shares in the responsibility for maintaining order and cleanliness of the department
- Maintains a level of productivity suitable for the department
- Other duties as assigned
Source : Conway Regional Heath System