Job Description
Red Scissor Pharmacy is looking for an experienced, proactive Prior Authorization Specialist to manage the submission, tracking, and processing of medication prior authorizations for patients and providers. The hours for this role are 5 days per week (around 40 hours paid on an hourly or weekly basis), with a minimum of 3 days per week in-person in our New York office.
Responsibilities:
Own day-to-day management of prior authorizations, including ensuring all relevant information is captured, communicating with insurance companies, and managing the follow-up process.
Communicate with providers and medical office staff to request information, share authorization decisions and determine the best next steps for each patient and avoid treatment delay
Provide exceptional service to patients via phone and message
Manage multiple priorities and maintain a high quality of work in a fast paced environment
Become an expert in various disease states and collaborate with our technical team and leadership on continuously improving our prior authorization process
Requirements:
2+ years experience working in a high volume health system, specialty pharmacy, or administrative and patient-facing role in a specialist medical practice
Exceptional knowledge of medical insurance, PBM requirements, and how to troubleshoot medication related prior authorizations
Ability to interpret, transcribe, and troubleshoot prescription information
Demonstrable ability to learn and operate new software systems and other relevant technology, including Google Suite (Sheets, Docs, etc.) and EHRs
Excellent customer service skills to communicate clearly, compassionately and effectively with patients from all backgrounds
Track record of working effectively with clinicians and other administrative staff in a healthcare setting
Very high level of detail orientation
We are an equal opportunity employer and value diversity of all kinds. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender, gender identity and expression, national origin, age, disability or protected veteran status. We celebrate diversity and are committed to creating an inclusive environment for all of our associates.