Prior Authorization Representative

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Primarily respond to phone inquiries from members, providers, and/or pharmacies.

• Address fax inquiries as necessary.

• Facilitate requests for medication prior authorization.

• Review system documentation and deliver clear, empathetic information.

• Utilize multiple applications to gather information.

• Adhere to standard operating procedures, corporate documentation, and HIPAA regulations.

• Research and resolve issues proactively, seeking help when required.

• Maintain precise and complete documentation of inquiries.

• Collaborate with colleagues to implement best practices.

• Achieve or surpass call center and other business performance metrics.

• Provide exceptional and consistent customer service.

• Participate in assigned training sessions.

• Complete assigned tasks and projects.

⛳️ Requirements

• High School Diploma or GED.

• Minimum of 1 year of customer service experience in a call center.

• Outstanding customer service and communication abilities.

• Strong organizational skills.

• Intermediate proficiency in Microsoft Outlook.

• Basic knowledge of Windows operating systems.

• Capability to navigate multiple screens and applications.

• Ability to remain composed and helpful in challenging situations.

• Flexibility to accommodate extended hours and overtime as required by business needs.

• Maintain 100% attendance during training/on-the-job training and demonstrate excellent attendance thereafter.

• Must reside in a DoD SCA County.

• Must be available for any schedule within operating hours from 7:00am to 10:00pm Eastern Time, Monday through Friday.

• Reliable high-speed broadband internet connection with a wired connection of at least 10 Mbps download and 5 Mbps upload.

• Quiet and private workspace free from interruptions.

• Healthcare background is preferred.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical, vision, and dental benefits starting from day one.

• Access to well-being and behavioral health programs.

• 401(k) plan.

• Company-sponsored life insurance.

• Tuition reimbursement opportunities.

• A minimum of 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence available.

• Option for a work-from-home arrangement.

• Requirement for a hard-wired high-speed broadband internet connection for remote work.