Description
Re-Authorization Representative
Location: This position will work a hybrid model (1 day from home). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint Altamonte Springs, FL location.
Work shifts: 10am-7pm EST
BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.
The Authorization Representative I is responsible for the completion and submission of appropriate forms for patients whose health plan requires drug re-authorizations for different therapy types.
How you will make an impact:
Primary duties may include, but are not limited to:
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Enters re-authorizations into the portal and ensures accurate completion of re-authorization forms.
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Submits completed re-authorization forms to the appropriate insurance plans.
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Maintains log of all re-authorizations submitted.
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Follows up with the patient's insurance company or physician office by phone, email or spreadsheets on all submitted re-authorization for patient approval/denial status.
Minimum Requirements:
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Requires a HS diploma or GED and a minimum of 1 year of experience processing pharmacy prior authorizations; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
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Specialty pharmacy experience highly preferred
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Prior Authorization experience highly preferred
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Knowledge of reading claims preferred
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Insurance verification preferred
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Knowledge of Medical Terminology preferred
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Familiarization with Specialty Drugs preferred
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At least one year of experience working in a Retail or Specialty Pharmacy preferred
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.