Prior Authorization and Benefits Specialist - Atlanta, United States - A-Line Staffing Solutions

Description

Job Title: Prior Authorization and Benefits Specialist

Pay: $17.50 an hr | Bi-weekly

Job Type: Remote

Shift Options:

• Hours: Mon-Fri 7AM-8:30PM CST. Training hours: Mon-Fri 8AM-4:30PM CST for 4 weeks.

Prior Authorization and Benefits Specialist Overview:

• The Commercial PA Representative I will work closely with providers to process prior authorization PA and drug benefit exception requests on behalf of CVS Health as the client and in accordance with Medicare Part D CMS Regulations.
• Must apply information [provided through multiple channels] to the plan criteria defined through work instruction.
• Research and conduct outreach via phone to requesting providers to obtain additional information to process coverage requests and complete all necessary actions to close cases.
• Responsible for research and correction of any issues found in the overall process.
• Phone assistance is required to initiate and/or resolve coverage requests.
• Escalate issues to Coverage Determinations and Appeals clinical pharmacists and management team as needed.