Prior Authorization Assistant

• Type: 6-month contract
  
• Schedule: Monday-Friday either 8-4, 9-5, 10-6 with a lunch. Once training is over, you are required to work at least 1 shift per week until 6PM.
• Pay: $20/hr
• Hybrid flexibility
  

The Prior Authorization Assistant handles triaging, logging, and follow-up of prior authorization, appeal, and grievance requests to ensure timely resolution and regulatory compliance. They also provide administrative support such as faxing, copying, filing, and preparing documents for scanning.

Key Duties:

• Assist Clinical Pharmacist by verifying member/provider eligibility and filing requests
• Log prior authorization requests into systems, ensuring accuracy
• Update documentation systems with decisions
• Fax and prepare requests for scanning and mailing.
• Help maintain drug policies and update the policy tracker.

• High School diploma or GED required; Associates degree preferred.
• One (1) year of experience in pharmacy and/or health insurance operations 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.
• 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.