Prior Authorization Specialist I

MedImpact Healthcare Systems, Inc.; Tempe (AZ); On-site; USD 24,000 - 38,000; Full time

Benefits offered by this job

Medical / Dental / Vision / Wellness

Paid Time Off / Holidays

Incentive Compensation

401K with Company match

Life and Disability Insurance

Tuition Reimbursement

Employee Referral Bonus

Job summary

MedImpact Healthcare Systems, Inc. is seeking a Prior Authorization Clerk to process and finalize PA requests within client turnaround times. You will enter PAs, prioritize, verify formulary compatibility, and communicate status to physicians and pharmacies.

Collaboration with clinical pharmacists is essential to ensure proper boundaries and timely decisions. The role requires at least a GED/HS diploma with 1+ year of related experience, with focus on accuracy, confidentiality, and service

Qualifications

• GED/HS Diploma and 1+ year experience or equivalent combination of education and experience

Responsibilities

• Process and finalize Prior Authorization (PA) requests within clients’ turnaround time and Performance Guarantees utilizing guidelines.
• Enter PAs into the system and prioritize requests; check formulary alternatives and review tried and failed medications.
• Coordinate notifications to members, physicians, and pharmacies to obtain missing information and communicate determinations.
• Collaborate with clinical pharmacists to ensure adherence to administrative processing boundaries and timeframes.
• Protect confidentiality and privacy of all PA information and related documents.

Education

GED/HS Diploma

Job description

MedImpact Healthcare Systems, Inc. is seeking a Prior Authorization Clerk to process and finalize PA requests within client turnaround times. You will enter PAs, prioritize, verify formulary compatibility, and communicate status to physicians and pharmacies.

Collaboration with clinical pharmacists is essential to ensure proper boundaries and timely decisions. The role requires at least a GED/HS diploma with 1+ year of related experience, with focus on accuracy, confidentiality, and service