Clinical Prior Authorization Technician (temp To Hire)

Capitalrx

Remote, US
**
Identify clinical guidelines
Obtain clinical information
Problem-solving skills
** Capital Rx is seeking a Clinical Prior Authorization Technician for a remote position to assist in preparing complex prior authorization requests and ensuring that clinical guidelines are met. The ideal candidate will have strong problem-solving skills and be able to effectively communicate with various stakeholders in the healthcare process. **

Job Summary

  • Prepares complex prior authorization requests by identifying clinical guidelines for review and ensuring substantial clinical information exists to reach a clinical determination for pharmacist review.
  • Proactively obtains clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review.
  • Effectively use problem solving skills to identify gaps and obtain relevant details to resolve client, member, pharmacy personnel, and provider concerns.

Matching Summary

Match Score: 75

** Capital Rx is seeking a Clinical Prior Authorization Technician for a remote position to assist in preparing complex prior authorization requests and ensuring that clinical guidelines are met. The ideal candidate will have strong problem-solving skills and be able to effectively communicate with various stakeholders in the healthcare process. **

Skills & Requirements

Must-have

  • Identify clinical guidelines
  • Obtain clinical information
  • Problem-solving skills
  • Analyze pharmacy claims data

Nice-to-have

  • Rebuilding trust in healthcare
  • Enterprise Health Platform

Key Requirements

  • Prior Authorization
  • Clinical Guidelines
  • Pharmacy Claims Data

Work Rights

Not specified

Tailored Resume

Cover Letter