FT - Authorization Specialist I - Murfreesboro, TN Job at TwelveStone Health Partners, Murfreesboro, TN

eEZxRXFsNHM1SzB5SVpaTTh2emYyUVcxTWc9PQ==
  • TwelveStone Health Partners
  • Murfreesboro, TN

Job Description

TwelveStone Health Partners is focused on the medication needs of patients with chronic, complex and rare conditions. For more than 35 years, TwelveStone Health has been dedicated to finding new ways to deliver care designed around the patient.

TwelveStone Health Partners supports the transition from acute to post-acute care environments and the journey from sickness to health. We are currently licensed in 50 states.

Summary: We are currently hiring for the position of full-time Authorization Specialist I at our corporate office located in Murfreesboro, TN. This position is responsible for obtaining prior authorizations for referrals for the infusion centers.

Essential Duties & Responsibilities

• Responsible for initializing prior medical/pharmacy authorization requests that are assigned. Follow the Prior Authorization Criteria for medications and submits requests.

• Communicate with insurance companies to pre-certify/authorize medications.

• Obtain clinical information (including but not limited to medical history, diagnosis, and any relevant lab reports) necessary to complete the Prior Authorization. Reviews the clinical information for completeness for insurance requirements and follows up with any questions.

• Assist with any denied claims to resolve potential mistakes by providing clinical information and/or coordinating with appropriate departments.

• Perform duties and job functions in accordance with the policies and procedures established for the department and any other duties as assigned.

The successful candidate will possess the following knowledge, skills and abilities:

Education: High school diploma or GED required

Experience: One year related experience and/or training with an healthcare organization, retail, or mail order pharmacy, or PBM. Experience with completing referrals and navigating insurance portals and orders. Experience working in a highly productive department with strong metrics accountability/ownership.

Functional Competencies: Attention to detail, critical thinking, problem solving, approachable, phone etiquette, dependable, verbal and written communication, teamwork, cooperation, collaboration, judgment, initiative, follow-through, Ability to prioritize and multi-task when presented with multiple duties, Self-starter with the ability to work independently and as part of a team.

Job Tags

Full time, Currently hiring,

Similar Jobs

Sol Dias Ice Cream

Fulfillment Specialist Job at Sol Dias Ice Cream

 ...provide delicious flavors of Mexico via handcrafted treats and hard-to-find Mexican snacks. You can find our products via Sam's Club, DoorDash, or our two brick & mortar positions. Our goal with every order is to deliver a piece of joy, and share the friendly culture of... 

Gpac

Remote Recruiter Job at Gpac

 ...largest and most successful executive search firms in the country, with over 5 20 search consultants. We do not require previous recruiting experience because we provide the proper training, tools, resources and support to reach your individual earning goals. We also... 

Clear Flow Gutter Guards

Brand Ambassador Job at Clear Flow Gutter Guards

We are seeking a brand ambassador to work our booth at home shows, festivals, fairs, etc. that feature our product. There are no sales. You would just engage in conversation to gather leads for our sales reps to call upon after the event. Have fun while making money!!!... 

IMI Industrial Services Group

Electrician Job at IMI Industrial Services Group

IMI is currently looking for a full time Electricianlocated LOCAL to the Athens, GA area. Individuals must be willing to work within a...  ...and decision-making based on quantifiable information. Some travel is required butlimited. Per Diem would be included.... 

Avenues: The World School

Chinese Teacher (Grades 6-10) Job at Avenues: The World School

 ...all offers are contingent upon successful completion of careful reference and background checks. QUALIFICATIONS Avenues Chinese teachers bring all or most of the following: Several years of teaching experience in Chinese and an exemplary track record of...