Exceptional HR Solutions, LLC

Prior Authorization Specialist

• Utilize and comprehend eClinicalWorks, including telephone encounters, chart notes, and provider directives
• Verify insurance coverage and prescription formularies to ensure prescription payment
• Submit prior authorizations to insurance companies via phone, fax, and electronic systems
• Answer incoming calls and address patient concerns and questions regarding authorization status and process
• Maintain accurate documentation of authorizations and prior approvals
• Work directly with insurance companies, pharmacies, and providers to resolve authorization issues
• Monitor and track established patient prescription authorizations
• Work closely with providers, Ideal Option staff, and pharmacies to ensure the best patient care
• Represent Ideal Option professionally and with a positive attitude
• Comply with national PHI laws including HIPAA and 42 CFR Part 2
• Perform other duties as assigned by supervisor

Explore Prescription Prior Authorization Specialist at Exceptional HR Solutions, LLC. Review requirements and application details.