Prior Authorization Specialist

 Posted 2 hours ago
     
0-2 years experience
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AI Summary

The Prior Authorization Specialist is responsible for verifying patient insurance eligibility and obtaining necessary prior authorizations from insurance carriers. They must also document all communications, resolve authorization roadblocks, and maintain strict adherence to HIPAA regulations.
Company Overview

Brand-SelectRx-Logo

Founded in 1985, SelectQuote (NYSE: SLQT) provides solutions that help consumers protect their most valuable assets: their families, health and property. SelectRX, a subsidiary of SelectQuote, is prioritizing important population health initiatives focused on actively managed, high-touch patient experience by improving patient engagement and health literacy, simplifying the healthcare journey and facilitating better healthcare options through value-based partnerships.

 

SelectRX is a high touch, technology-driven specialized medication management pharmacy. We engage virtually with patients to ensure accurate prescription records are maintained in order to achieve improved prescription drug adherence. SelectRX does this by providing a personalized clinical approach driven by a robust technology platform to track adherence with a world-class pharmaceutical packing and distribution facility.


About the Role

The Prior Authorization Specialist is responsible for obtaining prior authorizations for all prescriptions that require insurance carrier authorizations. 

 

Supervisory Responsibilities: 

This position has no direct supervisory responsibilities. 

 

Essential Duties and Responsibilities: 

Contact insurance carriers to verify the patient’s insurance eligibility benefits and requirements Request track and obtain prior authorization from insurance carriers within the time allotted Request follow up and secure prior authorizations ahead of prescriptions leaving the pharmacy Communicate any insurance changes or trends among the team 

Maintains a level of productivity suitable for the department 

Clearly document all communications and contacts with providers and personnel in standardized documentation requirements including proper format 

Answering questions from patients clerical staff and insurance companies 

Identifying and resolving Prior Authorization roadblocks through various means including contacting physicians 

Participating in educational activities and attending staff meetings 

Maintaining the strictest confidentiality; adhering to all HIPAA guidelines and regulations 

 

Skills/Abilities:

Knowledge of medical billing/collection practice Knowledge of business office procedures 

Knowledge of basic medical coding and third-party operating procedures and practices Ability to operate a computer computer software and basic office equipment 

Ability to operate a multi-line telephone system 

Skilled in answering a telephone in a pleasant and helpful manner Ability to read understand and follow oral and written instructions 

Ability to establish and maintain effective working relationships with patients employees and the public 

Proficiency in reading writing and speaking English is required 

 

Education and Experience: 

Minimum 1 year of related experience required 

 

Certificates/Licenses/Registration:

Pharmacy Technician Certification required (PTCB or NHA)

Indiana and Pennsylvania State Pharmacy Technician license required, or willing to obtain before start date.

 

Physical Requirements:

Work is performed indoors with potential for exposure to safety and health hazards related to a home office environment. Could periodically travel to other office and operational sites.  Prolonged periods of sitting at a desk and working on a computer.

 

 

SelectQuote Core Values:

Service: We create positive customer experiences. 

Entrepreneurship: We create innovate & take risks. 

Leadership: We build & invest in high-performing teams. 

Empowerment: We embrace a changing environment. 

Courage: We challenge the status quo & drive continuous improvement.

Teamwork: We help support & celebrate each other.

 

Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.

At this time SelectQuote does not hire applicants who solely possess temporary work visas requiring employer sponsorship of any kind including but not limited to OPT, H-1B, L-1, O-1, TN, F-1, J-1, E-3, etc.

SelectQuote Insurance Services does not discriminate against any applicant for employment, or any employee because of age, color, sex, disability, national origin, race, religion, or veteran status.


Our Benefits

The Compensation for this position is listed below. Local minimum wage laws apply. This information is posted pursuant to local requirements to provide applicants with information about what they might be eligible to receive. Individual pay decisions will depend on job-related factors such as experience, education, skill, performance, and geographic location where work will be performed.

Successful candidates may be able to participate in one or more incentive compensation or short-term incentive plans, which could generate additional earnings in accordance with the terms of each plan.

We are proud to offer the following benefits:

  • Competitive Medical, Dental, and Vision Insurance

  • HSA/FSA

  • Voluntary Hospital Indemnity, Critical Illness, Accident Insurance, and Short Term Disability

  • Voluntary Life Insurance for Self, Spouse and Dependent

  • Company-paid Basic Life Insurance and Long Term Disability

  • Retirement plan and Employer match contribution with Profit Share

  • Tuition Reimbursement program

  • Company perks and Discount program

  • Engaging Wellness and Financial Education Resources

  • Employee Assistance Program

  • Incentive Plans 

Base Hourly Minimum

$18.00

Base Hourly Maximum

$21.00

 

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