[Hiring] Medication Prior Authorization Specialist @American Addiction Centers

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description • Ability to complete insurance verification and eligibility checks. • Ability to collect and accurately document initial pre-certification/authorization information if available. • Initiates the process for obtaining a required referral/authorization if not obtained. • Ability to work assigned Epic work queue, following the department’s workflow process on appropriately transferring, deferring, or removing orders from the work queue. • Ability to proactively communicate issues involving customer service and process improvement opportunities to management. • Maintains excellent public relations with patients, patient's families and clinical staff. • Demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information. • Maintains knowledge of and reference materials for Medicare, Medicaid and third-party payer requirements guidelines and policies. • Ability to update the patient, physician's office, and any necessary parties regarding responses and outcomes of the prior authorizations. • Ability to act as a liaison between physician's office, patient, and pharmacy benefit manager to initiate and resolve appeals, as needed. Qualifications • High School Graduate. • Typically requires 1 year of experience in health care, insurance industry, pharmacy, or medical background. Requirements • Demonstrated ability to identify and understand issues and problems. • Knowledge and ability to articulate explanations of Medicare/HIPAA/EMTALA rules and regulations. • Mathematical aptitude, effective communication skills and critical thinking skills. • Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral/pre-certification/authorization processes. • Ability to speak effectively to customers or employees of the organization, maintaining a pleasant, professional demeanor. • Ability to handle sensitive and confidential information according to internal policies. • Ability to problem solve in a high profile and high stress area, working independently to set and meet deadlines and prioritize work. • Demonstrated technical proficiency including experience with insurance verification/eligibility tools, Epic electronic medical record, patient liability estimation tools, Microsoft Office, Internet Explorer and phone technology. Benefits • Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training. • Premium pay such as shift, on call, and more based on a teammate's job. • Incentive pay for select positions. • Opportunity for annual increases based on performance. • Paid Time Off programs. • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability. • Flexible Spending Accounts for eligible health care and dependent care expenses. • Family benefits such as adoption assistance and paid parental leave. • Defined contribution retirement plans with employer match and other financial wellness programs. • Educational Assistance Program. Apply tot his job