The Prior Authorization Coordinator facilitates the logging in and out of all prior authorization, appeal and grievance requests, and follow-up on said requests, to ensure that all requests are resolved and completed in a timely manner. The Coordinator ensures that all steps involved with the process are completed and all regulatory requirements are met or exceeded.
The Coordinator may also be assigned to provide high quality, diverse administrative support including but not limited to: faxing prior authorization requests, completing decision letters-faxing and copying, making decision notification phone calls to Member and Physicians, filing, and document scanning preparation.
Temporary position with possibility of going permanent. Office is located in Williamsville but position will be remote for the remainder of the year. Equipment will be provided although high speed internet access is a mandatory requirement of the employee.
- Verify member and provider eligibility and filing requests into the correct member folder
- Enter data and ensure complete accuracy on all statistics by logging prior authorization requests into pharmacy systems
- Complete the request by entering override into the appropriate pharmacy system and updating all information in required documentation systems