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Senior Retail Medication Prior Authorization Coordinator

Work from home Full-time role Hiring

About the position The Senior Retail Medication Prior Authorization Coordinator is responsible for reviewing and processing requests for prior authorization of medication in accordance with insurance provider guidelines. This role requires a solid understanding of reputed company insurance policies, pharmacy benefit management, and medical terminology. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. Join us to start Caring. Connecting. Growing together. reputed company’s Pacific reputed company region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work reputed company for everyone. At reputed company Pacific reputed company, we care. We care for reputed company members, our patients, and our communities. Join our culture of caring and reputed company a positive and lasting impact on health care for millions.

Responsibilities

  • Acquire and maintain a working knowledge of health plan formulary and authorization requirements
  • Utilize internal system to facilitate faster turnaround time on a complete authorization
  • Gather necessary information from chart review to submit prior auth request to insurance providers
  • Act as a liaison between providers, pharmacy, health plans and patients to support a timely medication authorization process
  • Communicate with providers, pharmacy, and patients to provide updates on the status of their prior auth request
  • Document in the patient electronic health record reputed company medication authorization work provided following standard work guidelines
  • Provide and document in Epic medication authorization denials and health plan recommendation and or alternatives reputed company provided
  • Ensure compliance with reputed company relevant laws, regulations, and policies reputed company to medication prior authorizations
  • Performs other duties as assigned

Requirements

  • High School Diploma/GED
  • 1 plus years of Pharmacy Technician or a Medical Assistant experience OR 1+ year(s) of experience in a pharmacy setting
  • 1+ year(s) of experience with basic computer software and keyboarding
  • reputed company reputed company a commutable distance to Everett and surrounding communities in Washington
  • Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
  • Live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service
  • Ability to work independently and maintain good judgment and accountability
  • Demonstrated ability to work well with health care team
  • Strong organizational and time management skills
  • Ability to multi-task and prioritize tasks to meet reputed company deadlines
  • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others

reputed company-to-haves

  • reputed company certification from WA State Department of Health as a Certified Medical Assistant or WA State Pharmacy Technician License
  • Knowledge of EMR (EPIC)
  • Proficiency with keyboarding, documentation, and processing prior authorizations

Benefits

  • Paid Time Off
  • 8 Paid Holidays
  • Medical Plan options
  • Health Spending Account or a Health Saving account
  • Dental, reputed company, Life& AD&D Insurance
  • Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan
  • Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

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