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Independent Health · 1 day ago

Prior Authorization Assistant

Buffalo, NY (14221)

Full-time

Hybrid

Entry Level

$20/hr - $20/hr

1+ years exp

Independent Health is an organization that values growth, innovation, and collaboration among its employees. The Prior Authorization Assistant facilitates the triage and logging of prior authorization, appeal, and grievance requests, ensuring timely resolution and compliance with regulatory requirements. Additionally, the role includes providing administrative support such as faxing and filing requests, and maintaining drug policy documentation.

Health CareInsuranceNon Profit

No H1B

Responsibilities

Assist Clinical Review Pharmacist in making appropriate decision by verifying member and provider eligibility and filing requests into the correct member folder. (Standard: 2 minutes per request /all requests will be triaged within 2 hours of receipt)

Enter data and ensures complete accuracy on all statistics by logging prior authorization requests into pharmacy systems. (Standard: 3.5 minutes per request / All requests will be logged in by end of business day

Updating information in required documentation systems. May also include transcribing Medical Director decision into systems. (Standard: 7 minutes per request/all requests will be completed within 24 hours of a pharmacist decision)

Provide Support for all required letters within required timeframes

Fax prior authorization requests including requests for additional information and completed requests

Copy and mail completed requests and related documents

Prepare completed requests for scanning into documentation systems

Maintain proper storage of all files, in accordance with the corporate retention policy

Assist the Supervising Pharmacist, Prior Authorization with copying and maintaining drug policies

Update the drug policy tracker accurately and timely

Qualification

Pharmacy experienceHealth insurance operationsDrug knowledgePC skillsMath aptitudeCommunication skillsOrganizational skillsTime managementProblem-solving

Required

High School diploma or GED required; Associates degree preferred

One (1) year of experience in pharmacy and/or health insurance operations required OR total six (6) months non-PBD associate (temporary) experience working within the same positions and/or department required

Proven written and verbal communication skills

Excellent organizational and time management skills

Excellent ability to absorb new concepts and adapt to a changing environment

Exhibit creativity and self-motivation, with ability to effectively solve problems as they arise

Demonstration of math aptitude for purposes of calculating simple drug requirements when given doses and prices calculations

Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring

Preferred

Pharmacy experience strongly preferred

General knowledge of drug names, therapeutic categories, dosage forms, manufacturers and packaging preferred

Familiarity with HMO concept, PC skills and pharmacy on-line system preferred

Benefits

Full range of benefits

Generous paid time off

Company

Independent Health

As one of Western New York's first HMOs, Independent Health covers approximately 355,000 people here and across the country with more than 100 plans, services and products.

Founded in 1980

Williamsville, Virginia, USA

1001-5000 employees