LanceSoft Inc., ยท 11 hours ago
Prior Authorization Specialist - Clinical Operations
United States
Full-time
Remote
Mid Level
$19/hr - $22/hr
3+ years expLanceSoft Inc. is a certified Minority Business Enterprise focused on connecting businesses with the right people. They are seeking a Clinical Services Consultant who will provide administrative support for Prior Authorization and act as a Subject Matter Expert for the Prior Authorization system, collaborating with various internal and external departments.
Information Technology & Services
Responsibilities
Drive quality execution of administrative support for Prior Authorization
Provide support for the Prior Authorization/Appeals Operational and Administrative teams
Work closely with and foster communications with internal and external departments including clinical development, product owners, CAS liaisons, Account Teams and Prior Authorization Operations
Configure criteria documents and fax forms into the Prior Authorization system daily, ensuring accuracy and completeness
Link workload to specific drug classes and clients
Validate all configurations for compliance and operational standards
Identify opportunities to improve processes and drive efficiencies within the department
Assist in leading meetings, creation and maintenance of work instructions, training, projects and activities related to PA systems
Work with a team of system trainers to provide consistent back-end user support
Assist in documentation and maintenance of user guides presentations and corrective action plans
Provide system demos and help guide CAS users through the implementation process for Prior Authorization system tool
Qualification
Required
3+ years of Pharmacy Benefit Management (PBM) prior authorization experience
Bachelor's Degree in any related field
Verifiable High School Diploma, GED, or equivalent
Preferred
Experience with PA system setup
Experience with MS Excel, Word and PowerPoint
Experience with CAS and/or MedHOK systems
Experience with Prior Auth and Appeals activities
Strong attention to detail and commitment to high-quality work
Company
LanceSoft Inc.,
Established in 2000, LanceSoft is a pioneer in delivering top-notch Global Workforce Solutions and IT Services to a diverse clientele.
5001-10000 employees
H1B Sponsorship
LanceSoft Inc., has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
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Trends of Total Sponsorships
2025 (55)
2024 (32)
2023 (23)
2022 (25)
2021 (60)
2020 (80)
Funding
Current Stage
Late StageCompany data provided by crunchbase