Clinical Services/Prior Authorization Representative

Clinical Services/Prior Authorization Representative

Locations: Miramar, FL

Schedule: Full-Time, Monday Friday

Pay Rate: $19.00/Hour

Description

ESSENTIAL DUTIES AND RESPONSIBILITIES include but are not limited to the following:

• Manage incoming and outgoing calls, documenting all calls in the dedicated application for call documentation.
• Handle letters from/to pharmacies, physicians, and healthcare providers in support of the Prior Authorization (PA) department.
• Analyze clinical PAs using the provided clinical protocols, and provide regarding PA requests based on provided documentation.
• Clarify any questions or concerns received from clients and/or internal departments.
• Assists with inquiries related to pre-authorizations referred by the account managers or other departments.
• Use online databases to document recommendations, clinical decisions, and responses.
• Deliver high-quality customer service in a fast-paced, dedicated PA program.
• Provide support on training new employees.
• Participate in training, conferences, orientations, and other activities related to your business unit.
• Must have a flexible work schedule to meet changing department needs.

QUALIFICATIONS AND REQUIREMENTS:

• Pharmacy technician certification (CPhT) required, registered preferred.
• Prefer 2 years experience working as a pharm tech or as a physician office assistant handling phone calls and reviewing charts.
• 1 year experience contacting other healthcare providers as part of daily job preference.
• Excellent communication skills working in a professional environment.
• Strong organizational skills working under time constraints in a constantly changing environment.
• PC experience to navigate new applications, with intermediate Excel and Word skills preferred.

Physical Demands:

• This role is primarily sedentary and requires the ability to sit for extended periods (minimum of 7 hours). The position required strong multitasking skills, attentions to detail, and the ability to lift and/o move up to 20 lbs.

The Perks of Joining Our Team:

• Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.
• Time to Recharge: Paid vacation and holiday pay.
• Focus on Your Wellness: We offer a robust Employee Wellness Program.
• Invest in Your Future: 401(k) with a company match.
• Support System: Employee Assistance Program provides confidential support and counseling.
• Get Rewarded for Referring Great People: Employee referral program.

Ready to start your rewarding journey with us? Apply today!

ProCare Rx will never ask for a financial commitment from an applicant, as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries, please contact our official recruitment team at View email address on click.appcast.io.

ProCare Rx is an Equal Opportunity Employer.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.