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Remote Customer Service Rep II

Mountain Brk, AL 35209

Posted: 04/03/2024 Employment Type: Contract Job Category: Administrative Job Number: 603384 Is job remote?: Yes Country: United States

Job Description


Pay 20-30/h depending on experience

The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. Representative will ensure patient insurance coverage and benefits, identify requirements for prior approval and submit for authorization. Assists with appealing prior authorization denials, retro authorization or other special cases

Responsibilities Include, But Are Not Limited To
  • Validates insurance patient’s coverage, communicate any issues with benefits or coverage to the appropriate managers
  • Checks the requirements for prior authorization and initiates as required
  • Coordinates required paperwork, clinical notes and forms for submission to support request and initiates as required
  • Follows up frequently to ensure visibility on authorization status throughout the approval process
Requirements:
  • Basic knowledge payer payment process with detailed knowledge on the payer prior authorization process
  • Basic ICD9/10 and CPT code familiarity, expert knowledge on subset of company therapy codes
  • Superior customer service skills with outstanding communication skills to use with various stakeholders; physicians, sales representatives, payer representatives, utilization reviewers, various internal and external stakeholders,
  • Advanced Microsoft Excel skills. Ability to learn and use multiple CRM software programs as needed
  • Good organizational skills with ability to handle multiple inquiries at the same time and critical problem-solving skills with high attention to detail

The staffing industry has seen an increase in people falsely representing themselves as recruiters to gather personal information from job seekers. For your safety, do not provide sensitive data to anyone you have not spoken with thoroughly and never provide banking information during the application process. Candidate safety is a top priority at Planet Pharma.

Planet Pharma and The Planet Group of Companies are equal opportunity employers. It is our practice not to discriminate against any employee or applicant based on any criteria, condition or basis protected by laws or regulations in the locations where we do business. All qualified applicants are encouraged to apply. We celebrate diversity and are committed to providing an environment of mutual respect. We believe that diversity, equity and inclusion enable us to better meet our mission and values while serving our clients across the globe. If you have a disability or handicap and would like us to accommodate you in any reasonable way, please inform your recruiter, or contact us, so that we can discuss the appropriate alternatives available.

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About Mountain Brk, AL

Discover exciting job opportunities around Mountain Brook, Alabama! Nestled in the scenic hills of Jefferson County, this charming suburb offers a blend of upscale living and tight-knit community spirit. With its vibrant arts scene, including the iconic Birmingham Museum of Art and the Alabama Theatre, as well as delectable Southern cuisine like the famous biscuits at Holler & Dash, there is something for everyone in this area. Whether you're drawn to the lush green spaces of Overton Park or the energetic ambiance of a Birmingham Barons game at Regions Field, Mountain Brook provides a perfect mix of work and play. Explore our job listings today and kickstart your career in this dynamic and enchanting locale!

Although this hasn't been an issue at Planet Pharma, the staffing industry has seen an increase in people falsely representing themselves as recruiters to gather personal information from job seekers. For your safety, do not provide sensitive data to anyone you have not spoken with thoroughly and never provide banking information during the application process. Candidate safety is a top priority at Planet Pharma.