Planet Pharma
Join to apply for the
Prior Authorization Representative
role at
Planet Pharma 5 days ago Be among the first 25 applicants Join to apply for the
Prior Authorization Representative
role at
Planet Pharma Get AI-powered advice on this job and more exclusive features. Job Description
Pay 22-24/h depending on experience
The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. Representative will ensure patient insurance coverage and benefits, identify requirements for prior approval and submit for authorization. Assists with appealing prior authorization denials, retro authorization or other special cases
Responsibilities Include, But Are Not Limited To
Validates insurance patient’s coverage, communicate any issues with benefits or coverage to the appropriate managers Checks the requirements for prior authorization and initiates as required Coordinates required paperwork, clinical notes and forms for submission to support request and initiates as required Follows up frequently to ensure visibility on authorization status throughout the approval process Basic knowledge payer payment process with detailed knowledge on the payer prior authorization process Basic ICD9/10 and CPT code familiarity, expert knowledge on subset of company therapy codes Superior customer service skills with outstanding communication skills to use with various stakeholders; physicians, sales representatives, payer representatives, utilization reviewers, various internal and external stakeholders, Advanced Microsoft Excel skills. Ability to learn and use multiple CRM software programs as needed Good organizational skills with ability to handle multiple inquiries at the same time and critical problem-solving skills with high attention to detail
The Planet Group of Companies is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Seniority level
Seniority level Not Applicable Employment type
Employment type Full-time Job function
Job function Other Industries Staffing and Recruiting Referrals increase your chances of interviewing at Planet Pharma by 2x Get notified about new Representative jobs in
Mystic, CT . Retail Banking - Part Time Customer Solutions Representative
B2B Account Executive - Small and Medium Business Direct Sales
South Kingstown, RI $15.00-$15.00 2 months ago Wireless Zone Sales Consultant-Verizon Wireless
Technical Customer Support Representative
Customer Service Representative/Flex Banker
Part Time Customer Service Representative $17 hourly
Customer Service Representative/Flex Banker
Mashantucket, CT $17.80-$24.10 2 weeks ago New London County, CT $86,000.00-$143,300.00 1 week ago Kingston, RI $46,524.00-$50,707.00 2 days ago Customer service representative - New London, CT
Mashantucket, CT $18.58-$19.71 4 weeks ago Mystic, CT $70,730.00-$104,500.00 2 weeks ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr
Prior Authorization Representative
role at
Planet Pharma 5 days ago Be among the first 25 applicants Join to apply for the
Prior Authorization Representative
role at
Planet Pharma Get AI-powered advice on this job and more exclusive features. Job Description
Pay 22-24/h depending on experience
The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. Representative will ensure patient insurance coverage and benefits, identify requirements for prior approval and submit for authorization. Assists with appealing prior authorization denials, retro authorization or other special cases
Responsibilities Include, But Are Not Limited To
Validates insurance patient’s coverage, communicate any issues with benefits or coverage to the appropriate managers Checks the requirements for prior authorization and initiates as required Coordinates required paperwork, clinical notes and forms for submission to support request and initiates as required Follows up frequently to ensure visibility on authorization status throughout the approval process Basic knowledge payer payment process with detailed knowledge on the payer prior authorization process Basic ICD9/10 and CPT code familiarity, expert knowledge on subset of company therapy codes Superior customer service skills with outstanding communication skills to use with various stakeholders; physicians, sales representatives, payer representatives, utilization reviewers, various internal and external stakeholders, Advanced Microsoft Excel skills. Ability to learn and use multiple CRM software programs as needed Good organizational skills with ability to handle multiple inquiries at the same time and critical problem-solving skills with high attention to detail
The Planet Group of Companies is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Seniority level
Seniority level Not Applicable Employment type
Employment type Full-time Job function
Job function Other Industries Staffing and Recruiting Referrals increase your chances of interviewing at Planet Pharma by 2x Get notified about new Representative jobs in
Mystic, CT . Retail Banking - Part Time Customer Solutions Representative
B2B Account Executive - Small and Medium Business Direct Sales
South Kingstown, RI $15.00-$15.00 2 months ago Wireless Zone Sales Consultant-Verizon Wireless
Technical Customer Support Representative
Customer Service Representative/Flex Banker
Part Time Customer Service Representative $17 hourly
Customer Service Representative/Flex Banker
Mashantucket, CT $17.80-$24.10 2 weeks ago New London County, CT $86,000.00-$143,300.00 1 week ago Kingston, RI $46,524.00-$50,707.00 2 days ago Customer service representative - New London, CT
Mashantucket, CT $18.58-$19.71 4 weeks ago Mystic, CT $70,730.00-$104,500.00 2 weeks ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr