Prior Authorizations Representative - Blue Sky Neurology

Summary:

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

Location:

Blue Sky Neurology
499 E. Hampden Ave., Suite 360
Englewood, CO 80113

Qualifications:

  • 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.

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