| Job Title: |
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Prior Authorization Specialist |
| Category: |
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Client Services |
| Total Positions: |
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1 |
| Job Location: |
|
Lahore |
| Gender: |
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No Preference |
| Minimum Education: |
|
Bachelors |
| Career Level: |
|
Experienced Professional |
| Minimum Experience: |
|
2 Years |
| Salary Range: |
|
PKR 50,000 to 60,000 per Month |
| Apply By: |
|
Aug 19, 2021 |
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| Job Description: |
- Apply clinical knowledge when assessing and responding with alternatives to denied pharmacy prior authorizations
- Collaborate with other departments to assist in obtaining prior authorizations
- Conduct denial reviews to provide recommendations for providers and support appeals submission if requested
- Document all prior authorization information including approval dates and authorization numbers within the patients record
- Facilitate medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
- Follow prior authorization work flow and policies and procedures
- Follow-up on all pending prior authorizations within 48 hours
- Identify insurance treatment requirements and review the patient medical record to assure the requirements are met for prior authorization approval
- Manage correspondence with insurance companies, physicians, pharmacies and patients as required
- Obtain approval/denial letters
- Process referrals and submit clinical supporting documentation to insurance carriers to expedite prior authorization processes
- Research and document coverage determination requests for prior authorization by independently researching the EMR chart notes and historical clinical data to identify prior therapies and treatments
- Review accuracy and completeness of information requested for prior authorizations and ensure all is appropriate and closely monitored
- Respond to urgent requests or emails submitted by the Provider in a timely manner
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| Company Information |
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Company Name: Medatron Pvt.Ltd
Company Description:
Pharmaceutical company
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