Prior Authorization Specialist

Prior Authorization Specialist

Curant Health, a leading healthcare company dedicated to personalized healthcare driven by choice and value, seeks a Prior Authorization Specialist to join its team in Smyrna, GA.

Responsibilities

• Taking inbound calls from providers, PBMs, etc., and providing phone assistance throughout the prior authorization process.
• Maintaining complete, timely, and accurate documentation of all approvals and denials, and transferring all clinical questions and judgment calls to the pharmacist.
• Aiding physician groups in initiating prior authorizations, following up with PBMs, and initiating appeals if necessary.
• Assisting with other duties such as outbound calls, monitoring/investigating inquiries, and other tasks as assigned by the Patient Services Manager.
• Managing work volume from start to finish, utilizing appropriate courteous and professional behavior based on established standards.
• Complying with departmental, company, state, and federal requirements to ensure accuracy of information provided to internal and external customers.
• Communicating with Patient Care Coordinators and other internal teams for timely resolution of appeals/exceptions.
• Providing general administrative support as assigned by the manager.
• Offering backup support to team members as needed.

Qualifications

• A high school diploma or equivalent.
• One year of experience as a Registered Pharmacy Technician.