M - F 9:00am -5:30pm
M - F 10am-6:30pm
Tues - Saturday 11:00am-7:30pm (Med D Biller Only)
Possible temp to perm
Act as a resource to the facilities in obtaining information completing necessary documentation or following
up on outstanding claims.
Certified Pharmacy Technician with an understanding of Insurance and Medicaid formularies and processes
including the prior authorization processes.
Makes outgoing calls to Facilities, Plans, and Physician's offices as needed to obtain approvals
Works with Client Billing Service Offices, Pharmacy Directors, customers and prescription drug plans to
effectively communicate and resolve customer issues.
Work closely with peers and management.
Performs other tasks as assigned.
Achieves productivity goals with regard to calls/claims per hour as determined by the Director and Clinical
Provide clinical support to members of the RxAllow team regarding prior authorization concerns
Conducts job responsibilities in accordance with the standards set out in the Company's code of Business
Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal
and State Laws, and applicable professional standards.
Familiar with the claim adjudication process.
Develop a strong understanding of the insurance verification, adjudication, back-end billing process and
become a subject matter expert on the insurance queues and billing workflow.
Prioritize work to meet daily and competing deadlines.
Proficiency in Microsoft Office.