Job Description

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***

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