Job Description
Job Description
In general, a Pre-Authorization Coordinator will be responsible for the following tasks:
- Gather ALL necessary information and supporting documents to comply with MCO requests in order to promptly determine treatment Authorization or Denial.
- Contact insurance companies or other payers to complete prior authorization requirements, identify the co- payment structure and investigate coverage and benefits;
- Communicating with patients to inform co-pay/deductible amount. and informing about Alivia’s Patient
- Assistance Programs (PAP). Referring to PAP, as appropriate.
- Conduct benefit coordination on behalf of patients, when applicable
- Determine patient eligibility
- Request authorization modifications, as needed.
- Index documents in patients’ records in a timely manner
- Respond to incoming calls with excellent customer service standards and following up with pending tasks (internal or external);
- Meet management’s production standards, whether quantitative or qualitative
Minimum requirements:
- Associate Degree Diploma with valid license as Pharmacy Technician is required.
- Minimum 1-year experience in customer service with knowledge of access processes to the most preferred benefits.
- Experience working with pre authorization processes or health plans is preferred.
**EEOC F/M/D/V***