Authorization Specialist

Authorization Specialist

We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time.

For this position, candidates must live within a commutable distance to one of the following locations (within 60 minutes):

• Malvern, PA (6 Spring Mill Drive)
• Mendota Heights, MN (2345 Waters Drive)
• San Diego, CA (12310 World Trade Drive)

Shift: Monday - Friday | 8:30am - 5pm CST or 9am - 5:30pm CST

Position Summary

Coram/CVS Health is looking for a high-energy healthcare professional to join our National team as an Authorization Specialist! This rewarding opportunity allows you to work closely with our Patient Intake Coordinators and insurance providers to obtain authorization for in-home Specialty therapies for Coram's patients. We believe that Authorization Specialists are a key part of creating a positive experience for our patients.

In this dynamic and fast-paced role, you will be responsible to obtain prior authorization information for both new and existing patients in order to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. This role will require an understanding of insurance carriers and concepts including pharmacy benefits, major medical benefits, and per diem coverage as well as knowledge of government and patient assistance programs.

Key Responsibilities:

• Complete and document Authorization
• Provides information on specialty medications/ home infusion services.
• Comply with and adhere to all regulatory compliance areas, policies, and procedures, and "best practices."
• Coordinate with the Patient Intake Coordinators for new and existing accounts.
• Investigate level of insurance coverage to assess Authorization for the program.
• Communicate with medical professionals and insurance company personnel.
• Provide input on self reviews
• Assist less experienced peers
• Perform other duties & responsibilities that are reasonable as assigned by your leaders

Required Qualifications

* Experience with benefits with insurance companies

* Experience with Authorization Requests

* Data entry experience.

* Working knowledge in Microsoft Office, specifically Outlook and Word.

Preferred Qualifications

* Home infusion or durable medical equipment (DME) experience.

* Experience work in a healthcare environment.

* Experience working with healthcare ins

Education

Verifiable High School diploma or GED is required

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $17.00 - $31.30

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.