Prior Authorization Reviewer (Remote within Alabama)

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes, making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Prior Authorization Reviewer to join our growing team.

Job Summary:

The Prior Authorization Reviewer:

• Reviews verbal and electronic prior authorization requests based upon pre-established criteria and approves or denies authorization.
• Receives incoming calls daily from providers and/or patients seeking assistance.
• Makes outbound calls as needed.
• Enters data project-specific information into the prior authorization processing system.
• Projects a professional company image through written and verbal interaction.

** This is a full-time, non-exempt (hourly) direct hire role with Benefits. **

** The required work Hours are Monday through Friday, 10:00 AM to 7:00 PM Central, and you may need to work over 30 to 60 minutes after the regular shift ends. **

 ** The selected candidate must also be willing to work alternating Saturday shifts from 10:00 AM to 4:00 PM Central. **

** This is a Remote position within the state of Alabama, where the selected candidate must also reside. **

** The selected candidate must have access to high-speed cable internet. **

Job Responsibilities:

• May approve, deny, dismiss/early close, or withdraw prior authorizations of medication according to guidelines as defined by the client.
• Answer incoming calls daily and in a timely manner.
• Assist callers with questions regarding approval or denial of medications.
• Research and resolve issues.
• Document the caller’s questions, issues, and resolution.
• Enter data information into the prior authorization processing system and correct errors as needed.
• Process Requests for Information (RFIs) for client accounts.
• Perform monitoring tasks of the HID/Client database and notify management of errors and/or problems.
• Maintain compliance with all company policies and procedures.
• Perform related duties as assigned by supervisor.
• Meet and/or exceed production, quality, attendance, and adherence standards.
• Provide/assist in training other employees.
• Subject to fingerprinting and background screenings as required.

The above list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

Requirements

Required Qualifications/Experience:

• High school diploma OR GED equivalent.
• Active National Certification of Pharmacy Technicians (e.g., PTCB CPhT OR ExCPT).

Preferred Qualifications/Experience

• Bachelor's degree from an accredited college/university.
• 1+ years of retail pharmacy and/or customer contact work experience in a healthcare environment.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement you need to achieve the finest work of your career.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may interest you. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

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Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The pay range for this position is $18.50-19.00 / hour.

“Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”