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In general, a Pre-Authorization Coordinator will be responsible for the following tasks: Gather ALL necessary information and supporting documents to comply with MCO requests in order to promptly determine treatment Authorization or Denial. Contact insurance companies or other payers to complete prior authorization requirements, identify the co-payment structure and investigate coverage and benefits; Communicating with patients to inform co-pay/deductible amount. and informing about Alivia’s Patient Assistance Programs (PAP). Referring to PAP, as appropriate. Determine patient eligibility. Request authorization modifications, as needed. Index documents in patients’ records in a timely manner. Respond to incoming calls with excellent customer service standards and following up with pending tasks (internal or external)
Requisitos - Requirements
Experience working with pre authorization processes or health plans is preferred. Exemplary communication skills, customer service, and skills to build customer relationships; including listening, speaking and writing. Associate Degree Diploma with valid license as Pharmacy Technician is required. Minimum 1-year experience in customer service with knowledge of access processes to the most preferred benefits.
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