Principal Admitting Worker PAL - Pharmacy Administration - FT Variable Shift

Position Summary:

Incumbent is responsible for initiating and submitting all necessary pharmacy order authorizations in accordance with established guidelines. Verifies eligibility, obtains benefit information, and obtains approvals for authorizations. Responds to provider and patient inquiries and resolves any identified authorization issues. Strong attention to detail skills, communication skills, and knowledge of healthcare processes to support utilization management are necessary to facilitate patient access to services

Required Qualifications:

• Strong organization, problem-solving, and critical thinking skills.
• Proficiency with Microsoft Office, especially Excel and Word; experience with authorization management systems a plus.
• Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
• Must demonstrate customer service skills appropriate to the job
• Minimum 1 year of experience in a managed care, medical office, or prior authorization setting (Medicare, Medi-Cal, commercial insurance experience preferred).
• Knowledge of the referral process, benefit interpretation, and health plan eligibility verification.
• Experience at working both independently and in a team-oriented, collaborative environment
• Excellent written and verbal communication skills in English
• Detail-oriented with strong follow-up skills.
• Ability to work weekends, holidays, and evenings
• Ability to manage multiple tasks, work with frequent interruptions, and meet deadlines.
• Ability to maintain a work pace appropriate to the workload
• Ability to interpret and understand various insurance plans and make accurate determinations regarding coverage
• Ability to establish and maintain effective working relationships across the Health System