Prior Authorization Specialist

Prior Authorization Specialist

Exciting opportunity with multiple openings!

Job Scope:
The purpose of this position is to help patients get access to the medications and therapies that they need. This role works directly with healthcare providers & insurance plans/payers to gather information about a patient s insurance and the coverage provided for a specific pharmaceutical product. The Patient Access Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications.

Title: Prior Authorization Specialist
Planned Start Date: 12/9/2024
Industry: Specialty Pharmacy Care
Work Location: Orlando, FL (Work Onsite Required) After that time, their overall performance, including attendance and program knowledge, will be assessed to determine if they are eligible for a work from home or hybrid schedule.
Pay: Up to $20.00hr Pay

Shift Options:
8am-5pm (1 hour lunch)
11am-8pm (1 hour lunch

Training Work Hours: TBD
Length of assignment: This is considered Temp to hire. If performance & attendance are met.

Preferred experience:
- Prior authorization (required)
- Healthcare & insurance experience

Job Description:
The purpose of the Prior Authorization Specialist is to meet or exceed the customer s expectations by assessing our customer s needs, assigning priorities, and triaging the information to the appropriate resources. (Customers may include patients, medical professionals, and family members.) The CSR will be able to function in a multidisciplinary team to provide information about the services that are offered by Patient Services

Major duties and responsibilities that are critical and necessary for this position and its overall objective:

• Act as first point of contact with patients by carefully evaluating the purpose of the call, carefully assessing their purpose, prioritizing their handling, and triaging the calls if indicated.
• Maintain information regarding Patient Services initiatives and explain them to our customers when appropriate.
• Enroll new customers to Patient Services.
• Record activities in the patient database and follow up to secure services (such as product training, mailing of promotional materials, etc.) for our customers by contacting physician s offices, pharmacies, and other external entities to ensure patient s needs are being met.

• Data Entry
• Need customer service for overflow help with other teams Accuracy creating accounts and cases
• Updating information in accounts from Med Billers and Requirements:
• Strong accurate data entry skills
• Previous work experience in Specialty Pharmacy or Customer Service preferable
• Professional level skills in computer use, including but not limited to Microsoft Office, email, web-based applications and key boarding skills
• Experience working with people in situations that are high-pressure and time-sensitive (either telephone or face-to-face), and that involve solving problems, making decisions, using excellent judgment and customer service skills. This can be obtained through a combination of work experience and post high school education, and need not be obtained in a traditional customer service setting
• Strong ability to multi-task and strong time management skills
• Ability to function in a high-volume, fast-paced environment
• Dependable and strong work ethic
• Ability to accept and implement feedback and coaching Specific type of experience preferred:
• Experience working with databases (CRM preferable) or a tracking system; Salesforce CRM experience
• Experience working in a health care/pharmaceutical industry environment
• Understanding of challenges associated with patients medical condition

• Minimum High School Diploma
• Experience working with databases (CRM preferable) or a tracking system; Salesforce CRM experience
• Experience working in a health care/pharmaceutical industry environment
• Understanding of challenges associated with patients medical condition
• Accustomed to working in high call volume environment.

SRG offers flexible staffing solutions with a national presence. We provide contract, contract-to-hire, direct hire and executive search services. SRG utilizes an innovative approach to identify and qualify talent that is unique to the Staffing industry, featuring a cutting-edge platform that allows us to rapidly and precisely match professionals to client requirements. We have a proprietary database of over one million candidates and maintain continuous contact with our qualified talent.

EOE/AOE
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