
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
.Take in-bound calls from members, providers, etc. and providing professional phone assistance
to all callers through the criteria based prior authorization process
. Maintain complete, timely and accurate documentation of all approvals and denials
. Transfer all clinical questions and judgment calls to the pharmacist
Will assist with other duties such as outbound calls, monitoring/responding to inquiries in
mailboxes and other duties as assigned by the leadership team
. Must be able to effectively manage work volume by handling inbound calls/fax requests utilizing
appropriate courteous and professional behavior based upon established standards
Comply with departmental, company, state, and federal requirements when processing all
information to ensure accuracy of information being provided to internal and external customers