This range is provided by SGS Consulting. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range
$18.00/yr - $21.00/yr
Team Lead (Recruitment) at SGS Consulting
Position Summary:
This is a high-volume inbound call position responsible for providing professional and courteous assistance to members, providers, and other callers. The role centers on supporting the criteria-based prior authorization process by reviewing clinical information and ensuring accurate documentation of all determinations.
Duties
Key Responsibilities:
- Handle incoming calls from members, providers, and other healthcare professionals.
- Deliver exceptional customer service while guiding callers through the prior authorization process.
- Review clinical documentation to determine completeness and eligibility based on established criteria.
- Accurately document all approvals and denials in a timely manner.
- Escalate clinical judgment calls and complex inquiries to the pharmacist for further evaluation.
- Maintain compliance with regulatory requirements and internal protocols.
Experience
- Minimum of 1 year in healthcare as a pharmacy technician (or comparable related role), and high call center type of environment (preferably in the medical field)
- National Pharmacy Certificate or State License is Preferred
- Strong computer skills, including proficiency in word processing and spreadsheet applications.
- Excellent verbal and written communication skills.
Education
- Verifiable High School diploma or GED is required.
Seniority level
Employment type
Job function
- Customer Service and Health Care Provider
- Industries: Hospitals and Health Care, Medical Practices, and Insurance