Prior Auth Spec

Duties/Responsibilities:

• Communicates and responds to customer needs in a professional, positive manner building credibility and rapport with providers and clinical teams, pharmacies, insurance companies, and patients.
• Employs a systematic approach to problem solving; makes decisions based on thoughtful analysis of the situation, and evaluation of the alternatives.
• Processes assigned tasks efficiently and accurately ensuring all tasks are completed.
• Maintains thorough knowledge of insurance plans Boice Willis Clinic participates in and protocols for each plan.
• Obtains proper forms for drug prior authorization submission.
• Communicates with clinical staff and physicians regarding prior authorizations in a timely manner.
• Thoroughly documents all communications.
• Performs other duties as assigned and requested.
• Complies with all Boice Willis Clinic policies.

Required Skills/Abilities:

• Ability to perform and maintain consistent workflow in busy high-pressure environment.
• Possess excellent communication skills both written and oral
• Possess analytical and situational assessment skills and can independently and appropriately react to situations
• Ability to work with variety of professionals and customers in a team environment
• Excellent customer service and organizational skills
• Knowledge of and/or experience with computer systems
• Medical office experience
• Medication prior authorization and insurance knowledge preferred
• Strong knowledge of medical terminology and pharmacology
• Excellent computer skills

Education & Experience:

• High school diploma or equivalent is required.
• Associate’s Degree in Medical Office is preferred.
• MA/CMA/RMA/LPN encouraged to apply