1 Prior Authorization Specialist Job in Columbus, NC
Blue Ridge Health is Hiring a Prior Authorization Specialist Near Columbus, NC
Blue Ridge Health is currently seeking a Prior Authorization Specialist to be part of our Medical team in Polk County.
What We Offer You::- A competitive benefits plan, including Medical, Dental and Vision
- Company sponsored life insurance and short and long-term disability coverage
- 403(b) retirement account with company matching
- Supplemental accident insurance available
- 9 paid holidays per year
- PTO and Personal Day accrual, starting day 1 - (We value a work-life balance!)
The Prior Authorization Specialist collaborates with patients, internal staff, other medical center representatives, and third-party payers to facilitate the smooth exchange of information related to obtaining timely prior authorizations for pharmaceutical and imaging patient needs. This is a regional support position that assists the PA process for three BRH locations. Responsibilities include:
- Applies clinical and pharmaceutical criteria for processing prior authorization requests in a timely manner for pharmacy needs.
Reviews notifications of patient prescription rejections via covermymeds.com, faxed document scanned directly to the desktop, or patient notification - Reviews received Medicaid prescription rejections in NCTracks
- Applies clinical and pharmaceutical criteria for processing prior authorization requests in a timely manner for imaging needs.
- Processes appeals and redeterminations as needed
- Assists in provider training or updates on efficiencies related to the prescription or imaging process prior authorization process.
- Communicates with appropriate parties in a timely and effective manner for completion of prior authorizations.
- High School Diploma or equivalent, required
Current North Carolina Pharmacy Technician, required - Strong knowledge of pharmacy terminology
- Experience working in an interdisciplinary and/or integrative health care model preferred
- Proficiency in MS Office programs required. Familiarity with Electronic Health Records (EHR) and other databases, preferred.
- Proficiency in Spanish a plus
At Blue Ridge Health our mission is to improve Health, inspire Hope, and advance Healing through access to Compassionate, Affordable, and Quality Care. We are seeking individuals with a passion for creating an exceptional patient and client care experience to join our team! We are a nonprofit system of Federally Qualified Health Centers (FQHCs) that works closely with communities to meet the ever-changing medical and behavioral healthcare needs of individuals throughout WNC.
We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Job Summary
Full Time
$35k-43k (estimate)
05/03/2024
05/18/2024
brchs.com
HENDERSONVILLE, NC
50 - 100
1963
Private
TONYA HARRIS
$10M - $50M
Business Services
Related Companies
The following is the career advancement route for Prior Authorization Specialist positions, which can be used as a reference in future career path planning. As a Prior Authorization Specialist, it can be promoted into senior positions as an Admitting Supervisor that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Prior Authorization Specialist. You can explore the career advancement for a Prior Authorization Specialist below and select your interested title to get hiring information.
If you are interested in becoming a Prior Authorization Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Prior Authorization Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Prior Authorization Specialist job description and responsibilities
Request, follow up and secure prior-authorizations prior to services being performed.
04/09/2022: Laramie, WY
Receive requests for pre-authorizations and ensure that they are properly and closely monitored.
03/28/2022: Schenectady, NY
Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
02/27/2022: Wichita, KS
Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.
04/08/2022: Altus, OK
Reported to supervisor to assure accurate capture of services needing authorization.
02/05/2022: Dothan, AL
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Prior Authorization Specialist jobs
Prior Authorization Specialist must have excellent computer skills including Excel, Word, and Internet use.
02/12/2022: New Britain, CT
A good Prior Authorization Specialist are those who are detail oriented with above average organizational skills.
03/28/2022: Galveston, TX
Basic understanding of human anatomy, specifically musculoskeletal would also give you benefits for this role.
04/04/2022: Lebanon, PA
Some experience in medical billing or insurance authorization are strongly preferred by most employers.
03/10/2022: Jamestown, NY
Licenses and certifications are not usually required to work as a prior authorization specialist.
04/02/2022: Mcallen, TX
Step 3: View the best colleges and universities for Prior Authorization Specialist.
