Job Responsibilities:
- The Tech I will also assist with other duties such as outbound calls, monitoring / responding to inquiries in mailboxes and other duties as assigned by the leadership team.
- Effectively manage work volume by handling inbound calls / fax requests utilizing appropriate courteous and professional behaviour 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.
- This position takes in-coming calls from members, providers, etc. providing professional phone assistance to all callers through the criteria based prior authorization process.
- Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions and judgment calls to the pharmacist.
Duties:
- Analyse clinical algorithms and provide decisions regarding PA Requests.
- Use of online databases and other resources to document appropriate recommendations, clinical decisions and responses.
- Provide ongoing education on the PA Program to healthcare providers and internal partners.
- Deliver the highest quality customer service to healthcare providers and internal providers in a high paced dedicated PA program.
- Ability to deal with a diverse customer base in a friendly and confident manner (internal and external customers).
- Excellent communication skills (oral, written, grammar, listening).
- PC Windows experience required.
- Ability to maintain confidentiality.
Shift Times:
Training Information:
- Training During Day from 9/29 - 10/10 (Monday - Friday)
- Shift: 6:00AM - 2:30PM
Experience / Education:
- Minimum three years’ experience required in a customer service position with high volume call centre experience
- Preferably in healthcare, social services, or a similar service position.
- Prior Authorization requires a cpht for the role along with a High School Diploma or GED.
All your information will be kept confidential according to EEO guidelines.
