Prior Authorization Coordinator - Remote in Everett, WA

Company: 340B Health
Location: Washington
Posted on: November 1, 2024

Job Description:

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Optum's Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions. The Prior Authorization Coordinator is responsible for reviewing and processing requests for prior authorization of medication in accordance with insurance provider guidelines. This role requires a solid understanding of healthcare insurance policies, pharmacy benefit management, and medical terminology. This role will be fully remote following a 1-3 month onsite training period. Candidates must reside near Everett or must be willing and able to commute to the Everett office at their own expense for training. If you reside near Everett, WA, you will enjoy the flexibility to telecommute as you take on some tough challenges. Primary Responsibilities:

• Acquire and maintain a working knowledge of health plan formulary and authorization requirements
• Utilize Cover My Meds system to facilitate faster turnaround time on a complete authorization
• Gather necessary information from chart review to submit prior auth request to insurance providers
• Act as a liaison between providers, pharmacy, health plans and patients to support a timely medication authorization process
• Communicate with providers, pharmacy, and patients to provide updates on the status of their prior auth request
• Document in the patient electronic health record all medication authorization work provided following standard work guidelines
• Provide and document in Epic medication authorization denials and health plan recommendations and/or alternatives when provided
• Ensure compliance with all relevant laws, regulations, and policies related to medication prior authorizations Required Qualifications:
  • High School Diploma/GED (or higher)
  • Current certification from WA State Department of Health as a Certified Medical Assistant OR Licensed Pharmacy Technician
  • 1+ year(s) of experience with basic computer software and keyboarding
  • 6+ months of experience as a Pharmacy Technician or Medical Assistant Preferred Qualifications:
    • Proficiency with keyboarding, documentation, and processing prior authorizations *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Washington Residents Only: The hourly range for Washington residents is $16.54 to $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
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Keywords: 340B Health, Wheaton-Glenmont , Prior Authorization Coordinator - Remote in Everett, WA, Other , Washington, Maryland