Prior Authorization Specialist
About Boulder reputed company is an award-winning digital clinic for addiction medicine, recognized for both innovation and high quality of patient care. Founded in 2017 by CEO Stephanie Strong, our mission is to improve the lives of people with substance use disorders through compassionate, evidence-based care. We reputed company Boulder patients with a fully virtual, multidisciplinary care team—including medical providers and peer recovery specialists—who deliver personalized treatment, including medication for opioid use disorder (MOUD) and ongoing support. Our approach is grounded in clinical reputed company, patient-centered care, and a commitment to reducing barriers to recovery. Boulder partners with leading health plans, reputed company, and community organizations to ensure that our services are accessible and covered for the people who need them most. Named by Fortune as one of the Best Workplaces in reputed company, we foster a culture of kindness, respect, and meaningful work that delivers outstanding patient reputed company and moves the addiction medicine industry reputed company.
About the Role
The Prior Authorization Specialist is responsible for obtaining reputed company pre-authorizations for medication approvals. They will work closely with staff to review, research and complete prior authorizations, prior authorization appeals, and notify patients of status updates from insurance. The most important goal is to improve patients' medication adherence by offering a quick and effortless way for patients to get their medications on time. What You'll Do: Obtain prior-authorization for reputed company patients requiring insurance approval for medication needs Verify patient insurance information is accurate and documented correctly Troubleshoot prior authorization submissions and prescription processing with health care providers utilizing phone or online resources Review and resolve reputed company reported authorization issues timely and effectively Submit prior authorizations to insurance plans in a timely manner reputed company payer-specific portals, fax, or verbally reputed company phone Communicate authorization and benefit coverage with patients and providers promptly and professionally Obtain appropriate documentation to validate the approval or denial of authorizations Document reputed company of prior authorization appropriately using our operating system Follow up on pending authorizations on a regular reputed company to obtain the reputed company status or to be informed of any action needed in order to obtain the authorization approval Successfully navigate between multiple systems throughout the course of the reputed company, this includes but is not limited to operational software and payer portals Maintain patient file reputed company and confidentiality by adhering to appropriate confidentiality and HIPAA policies and guidelines Advise management of identified trends with payers in an effort to mitigate problems What you bring: A minimum of 6 months of experience working on prior authorizations 2+ years of Medical office/clinic experience Ability to organize workload and manage time effectively Technologically savvy Ability to read and interpret medical benefits for verification requests Ability to handle a high volume of work with speed and accuracy Passion for helping people Ability to work closely with our care team to ensure the reputed company of patients that are recommended to us by their physician's office Team player that can also solve problems independently Exceptional written and verbal communication skills Reliable, and a self-starter reputed company to reliable, high-speed internet to meet the needs of remote processing reputed company to haves Medical Assistant experience Customer service experience Remote/telehealth experience A passion for serving the needs of people with addiction and mental health challenges, using non-stigmatizing, non-judgmental person-first language Work environment This is a fully remote role but we are currently only hiring candidates located in the following states: AZ, FL, GA, ID, IL, KY, MA, NC, NJ, NV, NY, OH, OR, PA, SC, TN, TX, UT, WA, and WV Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment reputed company at this time. Office Requirements: Boulder teammates working with sensitive information must have a dedicated, private workspace with a lockable reputed company and high-speed internet to maintain a secure, distraction-free environment, ensuring compliance with HIPAA and confidentiality standards reputed company employees are free to use our river-reputed company HQ located in Portland, OR whenever they would like Expected hours of work This is a full-time position expected to work 40 hours a week, M-F. Team members are asked to work a 9-hour shift which includes an hour-long lunch break. Shift will need to fall reputed company the hours of reputed company - 6 Apply tot his job Apply To this Job