Manager, Prior Authorizations
NateraSalary not specified
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Health Tech, PharmaceuticalsIndustries
Requirements
- Proven team player with the ability to solve problems independently
- Exceptional written and verbal communication skills
- Ability to adapt to new systems and workflow changes
- Experience working in prior authorizations, medical insurance billing, or health insurance (required)
- Working knowledge of ICD-10 codes and prescription drug names (preferred)
- Ability to navigate multiple systems throughout the workday (operational software and vendor portals)
- Customer service experience (preferred)
- Access to reliable, high-speed internet
Responsibilities
- Verifies patient insurance coverage utilizing phone or online resources
- Submits prior authorizations to insurance plans via electronic portal
- Troubleshoots prior authorization submissions and prescription processing with healthcare providers via phone or online resources
- Verbally assists providers in navigating appeals processing
- Ensures all pertinent medical documentation is accurate and present prior to authorization submission
- Compiles trends in authorization determinations for client and prescriber education
- Documents activities appropriately in process notes using the company’s operating system
- Works closely with the Customer Support team to ensure patient success
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
What is the work location or arrangement for this role?
This is a hybrid position requiring presence in either Scottsdale, AZ or Columbus, OH.
What is the salary for the Prior Authorization Specialist position?
This information is not specified in the job description.
What experience and skills are required for this role?
Required experience includes working in prior authorizations, medical insurance billing, or health insurance. Key skills are exceptional written and verbal communication, ability to solve problems independently as a team player, adapt to new systems, and navigate multiple systems.
What is the company culture or growth like at Philo?
Philo is a growing health-tech startup that recently completed Series D financing and expects to double its employee base in the coming year, with over 120 current employees.
What makes a strong candidate for this Prior Authorization Specialist role?
Candidates with required experience in prior authorizations, medical insurance billing, or health insurance, plus preferred knowledge of ICD-10 codes, prescription drug names, and customer service experience, stand out. Strong communication skills, adaptability, problem-solving, and reliable high-speed internet access are also essential.
Philo
Subscription-based streaming service for TV channels
About Philo
Philo offers a streaming service that gives users access to over 60 popular TV channels, such as A&E, AMC, and Comedy Central. It operates as an alternative to traditional cable subscriptions, allowing consumers to enjoy a variety of entertainment options without the high costs associated with cable. Users can subscribe to Philo on a monthly basis, and the service includes features like unlimited DVR, enabling them to record shows and watch them later. Philo can be accessed on multiple devices, making it convenient for users to watch their favorite programs anywhere. The company aims to provide a cost-effective and flexible viewing experience, appealing to those looking for a simpler way to enjoy television.
San Francisco, CaliforniaHeadquarters
2011Year Founded
$151.5MTotal Funding
SERIES_DCompany Stage
Consumer Software, EntertainmentIndustries
51-200Employees
