Prior Authorization Specialist- 2

Please submit the following to apply:

• Attach your resume, summary of relevant experience in United States-based prior authorizations, and an introductory video
• Please list 5 medications for which you have frequently completed prior authorizations and can discuss during an interview.
• Have you worked in a hospital or doctor's office completing medication prior authorizations? If so, please elaborate what platforms you have used to submit these.

About us
Job Summary:

We are seeking a dedicated Prescription Navigator to join our healthcare team. Squad Health offers navigation services and software to patients of medical practices to remove barriers to treatment, particularly prescription access. Navigation services include benefits investigation, prior authorization submission, patient assistance enrollment, pharmacy coordination, and patient engagement. Patient navigators will act as extensions of the providers we partner with, operating under general supervision of clinical staff.

Duties:

Verify benefits of patient’s insurance for review of drug and procedure orders
Obtain the appropriate authorization for services by completing authorization forms, while working with providers and their staff on unknown clinical questions:
Fill out clinical questions, including related diagnoses, based on medical notes and documentation
Fill out prescription questions based on prescription order and medication guidelines
Check status of pending authorizations and continue to work these.
STAT orders will require immediate, urgent attention.
Communicate with MD and NP’s if orders need to be changed on treatment plan or to discuss denials and request letter of medical necessity to appeal authorization denials
Obtain patient assistance support when out of pocket is unaffordable and identify that cost from the pharmacy.
Enroll patients into navigation program and obtain consent
Document all steps taken in research/process of the case entering information into the team database
Participate in tea ---------- etings to problem solve patient issues, and improve company operations on behalf of patients and partner practices
Skills:

2 years GI, dermatology, rheumatology, allergy specialty medication authorization experience required
Strong patient empathy and communication skills with patients, providers, insurances, pharmacies and other
Strong persistence and problem-solving skills; must be able to advocate for patient
Speak english fluently

This position offers the opportunity to make a meaningful impact on patients' lives while working in a collaborative healthcare environment. If you possess the required skills and are passionate about patient advocacy, we encourage you to apply for this rewarding role.

Job Type: Full-time
Work Location: Remote