Review requests from doctors and pharmacists to determine whether medication coverage prior authorization can be given by screening and reviewing requests based on benefit plan design, client specifics and clinical criteria.
Reports To: Office Manager, Manager of Practice
Blue Sky Neurology
499 E. Hampden Ave., Suite 360
Englewood, CO 80113
1+ year’s prior authorization experience
Ability to use electronic medical record and claims
Strong communication skills
Good phone etiquette and computer skills
Work well in a team environment
Essential Duties and Responsibilities:
Process telephone and written request from insurance companies
Review prior authorization requests
High call volume, 80+ calls per day, inbound
Strong data entry
Handle calls professional and provide accurate information in a timely manner
Other- Compliance, HIPAA and Security:
- Employees acknowledge that compliance with CarePoint’s and Practices HIPAA, Security and Compliance Plan policies and procedures as well as all other policies and procedures is a condition of employment and that any violation will result in sanctions up to and including termination based on the type and severity of the violation.
- Access to and use of Protected Health Information – security clearance which allows employees to review, investigate, and respond to questions from payors.
- Security access permitted using the Practice’s entrances for this job category is during core hours of the office, 5 days a week.