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The Medication Authorization/Refill Specialist is responsible for obtaining insurance authorizations answering phones maintaining and updating health care records and performing data entry. Responsible for medication refills and medication prior authorizations including the required medical documentation to support those requests and additional duties as assigned. This position requires a highly organized professional with excellent customer service skills phone etiquette knowledge of Microsoft Office applications fax machines internet software and knowledge of the authorization process with the various insurance carriers. Applicant must also be familiar with the prescriptions refill process and have some working knowledge of medications
Advocare LLC is a partnership of the top doctors in New Jersey and Pennsylvania including pediatricians family practice doctors and specialists. As part of the team youll work sidebyside with forwardthinking professionals who strive to provide the highest quality medical care by meeting and exceeding standards for clinical outcomes while delivering exceptional patient service in an evolving healthcare environment.
If you would like to learn more about us please visit our website: Functions:
Send all escripts to pharmacies for all providers.
Answer all prescription requests via refill line and fax.
Create new prescriptions when provider changes Rx due to denial or cost.
Order DME supplies Oxygen Auto CPaps Hospital beds wheelchairs and Diabetic Shoes.
Add or change ICD10 diagnosis codes rejected by insurances needing more specific coding.
Complete all Diabetic Medicare Forms for Diabetic Testing Supplies. Fax forms once completed by PCP for diabetic shoes. Include OV note from Podiatry.
Authorize all medication denials with prescription drug Insurance companies.
Authorize and order Prolia injections for osteoporosis and knee injections (Synvisc Synvisc One) that are private insurance EXCEPT Medicare. (Lolita orders these meds for Medicare patients).
Monitor E script change request for problems with clarifications denials out of stock on backordered prescriptions. Monitor failed prescriptions.
Required Skills/Abilities:
Education and Experience:
Required Experience:
Unclear Seniority
Full-Time