Pharmacy Prior Authorization Agent-specialty

Advocate Health

Base: $22.90 - $34.35 ph; bonus/equity: not specif...
Fully remote
Complete insurance verification and eligibility checks
Initiate prior authorization and referral processes
Communicate with patients and physician offices
The role involves completing insurance verification, collecting pre-certification information, and initiating the authorization process for specialty medications

Job Summary

  • The role involves completing insurance verification, collecting pre-certification information, and initiating the authorization process for specialty medications.
  • Employees act as a liaison between physicians, patients, and pharmacy benefit managers to resolve appeals and secure reimbursement or alternative options.
  • Advocate Health offers comprehensive benefits including health and welfare coverage, retirement plans, and educational assistance programs.

Matching Summary

The role involves completing insurance verification, collecting pre-certification information, and initiating the authorization process for specialty medications.

Salary

Base: $22.90 - $34.35 per hour; Bonus/Equity: Not specified; Benefits: Paid Time Off, Medical/Dental/Vision, Retirement match, Educational Assistance

Skills & Requirements

Must-have

  • Complete insurance verification and eligibility checks
  • Initiate prior authorization and referral processes
  • Communicate with patients and physician offices
  • Utilize Epic work queue systems
  • Manage incoming and outgoing calls

Nice-to-have

  • Proactive communication for process improvement
  • Knowledge of medical terminology
  • Ability to identify financial assistance programs
  • Collaborative teamwork with clinical staff
  • Problem-solving in high-stress environments

Key Requirements

  • High School Graduate education required
  • Typically requires 1 year of healthcare or insurance experience
  • No specific licensure or certification required

Work Rights

Not specified

Tailored Resume

Cover Letter