Prior Authorization Representative at US Tech Solutions, Inc.

Duration: 06 Months

Job Summary:

• Training and working virtually

• Utilizing multiple software systems to complete Medicare appeals case reviews

• Meeting or exceeding government mandated timelines

• Complying with turnaround time, productivity and quality standards

• Conveying resolution to beneficiary or provider via direct communication and professional correspondence

• Acquiring and maintaining basic knowledge of relevant and changing Med D guidance

Responsibilities:

• Working independently but be self-aware enough to know when to ask for help

• Be technically capable to understand trouble-shooting steps and be able to communicate the results to leaders or IT

• Ability to effectively communicate verbally with members and prescribers while managing multiple software systems

• Accountable and results driven

• Critical thinker/problem solver

• Receptive to constructive feedback and flexible in adapting to change

• Ability to effectively plan, prioritize, and organize time and workload

Experience:

• At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service

• Six months of working in a virtual role where the supervisor is not physically in the same space

• Six months of PBM/pharmaceutical related work strongly desired

Education:

• High School Diploma or GED required
• Bachelor’s degree in related field or equivalent work experience preferred

Skills:

• Call center, Prior authorization