Authorization Representative I - BioPlus Specialty Pharmacy

Elevance Health; United States; Remote; USD 42.000 - 52.000; Vollzeit

Zusammenfassung

BioPlus Specialty Pharmacy, a proud member of Elevance Health, seeks an Authorization Representative I to remotely manage pharmacy prior authorizations, ensuring accurate forms and timely submissions for patients. You will enter re-authorizations into the portal, submit to plans, maintain logs, and follow up with insurers or physicians to confirm approval or denial.

This role supports whole-health care delivery within Elevance Health's framework; requires a HS diploma and 1 year of authorization

Qualifikationen

• HS diploma or GED with 1 year of prior authorization experience.
• Equivalent education and experience considered.
• Experience with pharmacy prior authorizations preferred but not required.

Aufgaben

• Enters re-authorizations into the portal and ensures accurate completion of re-authorization forms.
• Submits completed re-authorization forms to the appropriate insurance plans.
• Maintains log of all re-authorizations submitted.
• Follows up with the patient's insurance company or physician office by phone, email or spreadsheets on all submitted re-authorization for patient approval/denial status.

Kenntnisse

Prior authorizations

Denials and appeals

Medical terminology

Certified Pharmacy Technician

Specialty pharmacy experience

Ausbildung

HS diploma or GED

Jobbeschreibung

Remote

BioPlus Specialty Pharmacy is a proud member of the Elevance Health family of companies. BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

The Authorization Representative I will be responsible for the completion and submission of appropriate forms for patients whose health plan requires drug re-authorizations for different therapy types.

How you will make an impact:

• Enters re-authorizations into the portal and ensures accurate completion of re-authorization forms.
• Submits completed re-authorization forms to the appropriate insurance plans.
• Maintains log of all re-authorizations submitted.
• Follows up with the patient's insurance company or physician office by phone, email or spreadsheets on all submitted re-authorization for patient approval/denial status.

Minimum Requirements:

• Requires a HS diploma or GED and a minimum of 1 year of experience processing pharmacy prior authorizations; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Certified Pharmacy Technician highly desired.
• Specialty pharmacy experience highly preferred.
• Medical terminology training is preferred.
• Experience with Prior Authorizations, Denials and Appeals highly desired.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.