Open To Work
Rebeca Lopez
Polaris Specialty Pharmacy
Downey,CA
Work Preference
Job Search Status:
Open to work
Desired start date:
Immediately
Desired Job Title
Prior Authorization SpecialistPharmacy Technician
Work Type
Full Time
Location Preference
Remote
Important To Me
Work from home option
7
Years of experience
Work History
Prior Authorization Specialist
7 Years 3 Months- Processed prior authorization requests efficiently to ensure timely medication access for patients.
- Reviewed clinical documentation for accuracy, facilitating approval processes with insurance providers.
- Collaborated with healthcare professionals to gather necessary information for prior authorization submissions.
- Maintained up-to-date knowledge of insurance policies and pharmacy benefits to enhance service delivery.
- Developed and implemented streamlined workflows to improve turnaround times on authorization requests.
- Addressed discrepancies in claims by coordinating communication between pharmacies, providers, and insurers.
- Analyzed trends in prior authorization denials to identify opportunities for process improvement and training needs.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Improved provider satisfaction with timely communications regarding authorization status updates.
- Facilitated cross-departmental training sessions to enhance understanding of prior authorization criteria and procedures.
- Conducted thorough reviews of medical documentation to ensure compliance with payer policies and patient care standards.
- Maintained up-to-date knowledge of changing healthcare regulations and insurance policies to ensure accurate processing of requests.
Timeline
Prior Authorization Specialist
Polaris Specialty Pharmacy
03.2019 - 06.2026Read More