Prior Authorization Assistant

Remote Full-time
Independent Health is an organization that values growth, innovation, and collaboration among its employees. The Prior Authorization Assistant facilitates the triage and logging of prior authorization, appeal, and grievance requests, ensuring timely resolution and compliance with regulatory requirements. Additionally, the role includes providing administrative support such as faxing and filing requests, and maintaining drug policy documentation. Responsibilities Assist Clinical Review Pharmacist in making appropriate decision by verifying member and provider eligibility and filing requests into the correct member folder. (Standard: 2 minutes per request /all requests will be triaged within 2 hours of receipt) Enter data and ensures complete accuracy on all statistics by logging prior authorization requests into pharmacy systems. (Standard: 3.5 minutes per request / All requests will be logged in by end of business day Updating information in required documentation systems. May also include transcribing Medical Director decision into systems. (Standard: 7 minutes per request/all requests will be completed within 24 hours of a pharmacist decision) Provide Support for all required letters within required timeframes Fax prior authorization requests including requests for additional information and completed requests Copy and mail completed requests and related documents Prepare completed requests for scanning into documentation systems Maintain proper storage of all files, in accordance with the corporate retention policy Assist the Supervising Pharmacist, Prior Authorization with copying and maintaining drug policies Update the drug policy tracker accurately and timely Skills High School diploma or GED required; Associates degree preferred One (1) year of experience in pharmacy and/or health insurance operations required OR total six (6) months non-PBD associate (temporary) experience working within the same positions and/or department required Proven written and verbal communication skills Excellent organizational and time management skills Excellent ability to absorb new concepts and adapt to a changing environment Exhibit creativity and self-motivation, with ability to effectively solve problems as they arise Demonstration of math aptitude for purposes of calculating simple drug requirements when given doses and prices calculations Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring Pharmacy experience strongly preferred General knowledge of drug names, therapeutic categories, dosage forms, manufacturers and packaging preferred Familiarity with HMO concept, PC skills and pharmacy on-line system preferred Benefits Full range of benefits Generous paid time off Company Overview As one of Western New York's first HMOs, Independent Health covers approximately 355,000 people here and across the country with more than 100 plans, services and products. It was founded in 1980, and is headquartered in Williamsville, Virginia, USA, with a workforce of 1001-5000 employees. Its website is
Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Experienced Full Stack Software Engineer – Web & Cloud Application Development

Remote

Content Associate, Computer Science (6-month contract, $100/hour, 30 hours/week)

Remote

Online Personal Trainer

Remote

New Business Sales - MSP Experience Required - Fully Remote

Remote

Experienced Full-Time Remote Data Entry Specialist – Accurate Data Management and Administrative Support at Blithequark

Remote

Mid-Level Project Manager (Consultant)

Remote

**Experienced Data Entry Specialist – Remote Opportunity at arenaflex**

Remote

Remote Entry-Level Data Entry Specialist – No Experience Required – Fully Trained, Flexible Remote Work, Career Growth Path

Remote

Genetic Counselor, Report Writer

Remote

Medical Policy Analyst (Remote Eligible), SD IA License

Remote
← Back