Medicare Prior Authorization and Appeals Representatives
A-Line Staffing Solutions
Remote job description
A-Line Staffing Solutions is Hiring Medicare Authorization and Appeals Representatives in San Antonio
**Position is REMOTE until Further Notice**
Position Summary:
Our client's purpose is to help people on their path to better health. As a Medicare Pharmacy Authorizations and Appeals Analyst, you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. This is a great opportunity to initiate a career with a leading healthcare company by completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience. Are you looking for a new opportunity to work from home? This role will allow you to do so, 100% remotely.
In this role, you will be responsible for:
- Utilizing multiple software systems to complete Medicare appeals case reviews
- Meeting or exceeding government mandated timelines
- Complying with turnaround time, productivity and quality standards
- Conveying resolution to beneficiary or provider via direct communication and professional correspondence
- Acquiring and maintaining basic knowledge of relevant and changing Med D guidance
SHIFT: 40 hours per week within operating hours of 7am – 8pm, Monday – Friday with a weekend rotation (every 4th weekend)
For immediate consideration, please send your resume to Michael Nichols at mnichols@alinestaffing.com
Required Qualifications:
- Accountable and results driven
- Critical thinker/problem solver
- Receptive to constructive feedback and flexible in adapting to change
- Ability to effectively plan, communicate, prioritize, and organize time and workload
- Dedicated home work space needed, must have stable high speed internet, be able to provide a quiet uninterrupted work environment, must have workstation that is not accessible to common traffic and is secure from unintentional access.
- Ability to execute successfully in a deadline-oriented, fast-paced, highly-regulated environment
- Proficient in navigation of multiple computer applications
- Proficient use of keyboard, mouse and ability to navigate 2 workstation monitors
- Preferred Qualifications:
- At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service
- Six months of PBM/pharmaceutical related work strongly desired
- Pharmacy Technician license preferred
Education:
- High School Diploma or GED required
- Bachelor's degree in related field or equivalent work experience preferred
For immediate consideration, please send your resume to Michael Nichols at mnichols@alinestaffing.com
Summary
A-Line Staffing Solutions
Medicare Prior Authorization and Appeals Representatives
Tags: Legal
-
category
Medical / Health -
hourly salary range
$12 - 13 -
posted
1297 days ago
https://www.remote.io/remote-medical-health-jobs/medicare-prior-authorization-and-appeals-representatives-7890