Prior Authorization Resolution Coordinator

About the position Opportunities with Genoa Healthcare. A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group’s family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together. The Prior Authorization Resolution Coordinator is responsible for preparation, review and completion of requests for prescription prior resolution support. Coordinator prepares documents related to prior authorization and/or appeal requests, verifying and updating patient/member profile information. This role also compiles medical notes (disease state, drug treatment history and current drug plan) in support of the request, performs outreach for additional information as needed to support the request, and submits prior authorization(s) for approval as an agent of the physician. Update approved requests in claims systems and inform healthcare team of outcome. When applicable, the coordinator forwards applicable requests through additional review path(s) and research financial assistance programs, as needed. You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Responsibilities

• Support prior authorization resolution in collaboration with Genoa Healthcare Pharmacy locations
• Initiate review and appeal process, when needed
• Aids in co-pay assistance set-up, when needed
• Manage reports to ensure all Prior Authorization requests are completed for Genoa Healthcare Pharmacy locations
• Generate reporting to monitor timely completion of prior authorizations resolution
• Completes administrative duties, which include processing mail and faxes, to aid in prior authorization resolution
• Research and stay up to date on insurance plan eligibility and prior authorization criteria
• Work independently to complete prior authorization needs from beginning to end and communicate with key stakeholders during the process
• Performs other projects, work, and activities as assigned to ensure continuous service to our patients and clients

Requirements

• High School Diploma/GED (or higher)
• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Nice-to-haves

• 2+ years of pharmacy operations experience
• 2+ years of experience with prior authorization resolution and ability to navigate associated technology and platforms
• Exceptional interpersonal and communication (verbal, listening) skills

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

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