Gastro Health Ohio is looking for a Prior Authorization Specialist to join our team! This specialist role will assist with authorizations for medications and Hepatitis C treatments through our pharmacy. An ideal candidate will be able to work independently, as well as collaborate with others on the team to ensure each task is handled in a timely manner.

Job Duties:

• Request, track, and obtain prior authorization from insurance carriers within time allotted for treatment/maintains a level of productivity suitable for the practice.
• Request, follow up and secure prior authorizations prior to starting therapy.
• Clearly document all communication and contacts with providers, patients and insurance personnel
• Contact insurance carries to verify patient's eligibility, benefits and requirements
• Maintain knowledge of insurance company requirements for Hep-C treatments
• Receive information from the pharmacy in regard to prior authorization requirements for certain medications
• Handle denials appropriately with the pharmacy and prescriber
• Must be able to review clinicals and be able to answer the questions required by insurance based off the clinical history.
• Must have some knowledge of medical terminology, high proficiency of general medical office procedures (including HIPAA law and procedure).
• Experience in a pharmacy or clinical setting preferred.
• Must have excellent verbal and written communication skills.

Job Duties:

• High school diploma or GED equivalent
• 2 years of health care insurance experience or similar medical setting required
• Medical terminology knowledge required
• eCW experience preferred

COVID-19 considerations:

Temperature checks at check-in, mask worn while on-premise, and hand sanitizing stations throughout the building

Interested in learning more? Meet our Team (https://gastrohealth.com/locations/reston).

Gastro Health is proud to be an Equal Opportunity Employer. We do not discriminate based on race, color, gender, disability, protected veteran, military status, religion, age, creed, national origin, gender identity, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

We thank you for your interest in joining our growing Gastro Health team!