CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

Responsibilities

Responsible for obtaining initial prior authorization and renewal authorizations for infusion services. Collaborates with clinicians regarding supporting medical documentation in accordance with formulary guidelines. Manage the quality review of requested prior authorizations.

Responsibilities

Obtains initial and renewal authorizations for infusion services from insurance companies via portal, phone, fax.

Ensures initial and renewal authorizations are followed up on in a timely manner.

Interface with other departments and identify medical documentation in support of prior authorization requests.

Notifies the patient, prescriber and internal teams of insurance denial/appeals process.

Prioritizes and completes assigned tasks on schedule.

Responds to chat/email update requests timely.

Utilizes appropriate communication lines in relaying problems, concerns, questions, and ideas.

Demonstrates the ability to work effectively and maintain expected productivity.

Meets quality standards, shows pride in performance, and demonstrates reliability and follow-through on all assigned tasks.

Demonstrates ability to communicate effectively and express ideas clearly.

Performs in accordance with system-wide competencies/behaviors.

Performs other duties as assigned.

Skills & Abilities

Team player

Gives high priority to client satisfaction and customer needs. Maintains confidentiality of patient information.

Provides customer service to all internal and external customers.

Good verbal and written communication skills.

Computer literate, with the ability to utilize standard software applications including Windows and MS Office Suite (Outlook, Word, and Excel).

Good organizational skills with attention to detail and ability to multitask.

Requirements

HS diploma or GED required.

1-2 years of prior authorization, insurance verification or other related experience in a physician practice, ancillary provider, or other relevant healthcare setting required.

Knowledge of medical terminology required.

Knowledge of payer websites, eligibility, coordination of benefits preferred.

Knowledge of pharmacy vs medical payers and authorization preferred.

Knowledge of plan formularies and authorization requirements preferred.

Proficient computer skills and Microsoft Office Products required.

CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.