US Tech Solutions
Prior Authorization Specialist
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Job Description
- Req#: 23-23751
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Fully remote position offering flexibility in work location
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on coverage requests and patient care
- Professional development through cross-training in various lines of business
What to Expect (Job Responsibilities):
- Handle inbound calls from providers, pharmacies, and members regarding prior authorization processes
- Maintain accurate and timely documentation of reviews and coverage requests
- Collaborate with the pharmacist team for clinical questions and escalations
- Process prior authorization and drug benefit exception requests in accordance with Medicare Part D CMS regulations
- Research and resolve issues related to coverage requests and ensure compliance with CMS standards
What is Required (Qualifications):
- Minimum of 0-3 years of experience in a customer service or call center environment managing high call volumes
- At least six months of experience in PBM/pharmaceutical-related work is strongly desired
- Minimum of two years of general business experience, including problem resolution and customer service
- High School diploma or GED required
- Strong call handling and communication skills
How to Stand Out (Preferred Qualifications):
- Experience in prior authorization processes
- Knowledge of Medicare and Medicaid regulations
- Familiarity with quality improvement and business writing
#HealthcareServices #RemoteWork #CustomerService #CareerOpportunity #PriorAuthorization
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Our Talent Your Results - This is the premise behind US Tech Solutions. Our flexible engagement model offers right-fit talent on-demand - when, where and how you need it, so you can achieve your business objectives. We offer contingent, contract-to-hire or direct staffing services. At USTECH, we understand how critical talent is to every organization, as well as how the world of work and the workplace is changing. We offer the most effective means to help you acquire, manage and optimize talent. USTECH was founded in 2000 by Manoj Agarwal. Today, we are a global firm offering talent solutions to 150 customers including 20% of Fortune 500 across Financial Services, Healthcare, Life Sciences, Aerospace, Energy, Retail, Telecom, Technology, Manufacturing, and Engineering.
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