Medication Access Navigator

LMH; Lawrence (KS); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Tuition reimbursement

Professional development

Excellent benefits

Job summary

LMH Health in Lawrence, Kansas is seeking a Medication Prior Authorization Specialist to coordinate insurance prior authorizations for applicable patient prescriptions. This role interfaces with providers, insurers, and patients to verify coverage and obtain authorizations.

Responsibilities include monitoring prior authorization work queues, using online and telephony channels to secure approvals, documenting in the medical record, and escalating complex cases when needed.

Responsibilities

• Monitors prior authorization work queues and verifies patient insurance information and eligibility.
• Obtains prior authorizations from insurance companies via online, fax, and telephony channels and documents in the medical record.
• Communicates updates to patients and providers throughout the process.
• Engages insurance company representatives to secure prior authorization with required clinical information.
• Escalates complex issues to Supervisor for guidance and involves care team when needed.
• Maintains knowledge of EMR systems and internal tools and participates in quality improvement activities.

Job description

LMH Health in Lawrence, Kansas is seeking a Medication Prior Authorization Specialist to coordinate insurance prior authorizations for applicable patient prescriptions. This role interfaces with providers, insurers, and patients to verify coverage and obtain authorizations.

Responsibilities include monitoring prior authorization work queues, using online and telephony channels to secure approvals, documenting in the medical record, and escalating complex cases when needed.