Remote Prior Authorization Specialist II — Patient Access

Planet Pharma; Roseville (CA); On-site; USD 50,000 - 70,000; Full time

Job summary

A healthcare organization in California is seeking a Prior Authorization Representative responsible for verifying prior authorization requirements and facilitating patient access to therapies. The role involves coordinating paperwork and communication with physician offices and payers for patient insurance coverage. Candidates should possess excellent customer service skills and have experience with insurance verification and the payer authorization process. Expertise in Microsoft Excel and organizational abilities are essential.

Qualifications

• Experience in verifying insurance patient’s coverage and communicating issues.
• Knowledge of ICD9/10 and CPT codes, particularly for Medtronic therapies.
• Ability to manage multiple inquiries with critical problem-solving skills.

Responsibilities

• Validate insurance patient’s coverage and communicate with managers.
• Check prior authorization requirements and initiate submissions.
• Coordinate paperwork and follow up on authorization status.

Skills

Insurance verification

Payer prior authorization process

Customer service skills

Advanced Microsoft Excel skills

Organizational skills

Tools

CRM software

Job description

A healthcare organization in California is seeking a Prior Authorization Representative responsible for verifying prior authorization requirements and facilitating patient access to therapies. The role involves coordinating paperwork and communication with physician offices and payers for patient insurance coverage. Candidates should possess excellent customer service skills and have experience with insurance verification and the payer authorization process. Expertise in Microsoft Excel and organizational abilities are essential.