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Posted Jul 23, 2021 4 views
PKR. 50,000 - 60,000/Month
- Apply clinical knowledge when assessing and responding with alternatives to denied pharmacy prior authorizations
- Collaborate with other departments to assist in obtaining prior authorizations
- Conduct denial reviews to provide recommendations for providers and support appeals submission if requested
- Document all prior authorization information including approval dates and authorization numbers within the patients record
- Facilitate medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
- Follow prior authorization work flow and policies and procedures
- Follow-up on all pending prior authorizations within 48 hours
- Identify insurance treatment requirements and review the patient medical record to assure the requirements are met for prior authorization approval
- Manage correspondence with insurance companies, physicians, pharmacies and patients as required
- Obtain approval/denial letters
- Process referrals and submit clinical supporting documentation to insurance carriers to expedite prior authorization processes
- Research and document coverage determination requests for prior authorization by independently researching the EMR chart notes and historical clinical data to identify prior therapies and treatments
- Review accuracy and completeness of information requested for prior authorizations and ensure all is appropriate and closely monitored
- Respond to urgent requests or emails submitted by the Provider in a timely manner
Job Details
Industry:
Functional Area:
Total Positions:
1 Post
Job Shift:
Third Shift (Night)
Gender:
No Preference
Minimum Education:
Bachelors
Career Level:
Experienced Professional
Minimum Experience:
2 Years
Apply Before:
Aug 20, 2021
Posting Date:
Jul 23, 2021
Medatron Pvt.Ltd
Services · 101-200 employees - Lahore
Pharmaceutical company
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