[Hiring] Medication Refill Prior Authorization Specialist I @Northern Light Health

Role Description

This is an entry level position. The Medication Refill and Prior Authorization Specialist is an essential member of the Northern Light Health team. The Specialist position supports a centralized service which assists with all aspects of the medication refill and prior authorization process including:

• Utilizing the electronic medical record to process refills
• Processing prior authorizations
• Providing call center support for the refill line for Northern Light Health practice patients across the State

Ideal candidates will have strong communication skills, ability to work independently and actively support patient-centered care with sensitivity and respect for all diversity of human experience. This is a remote, work from home, opportunity.

Responsibilities

• Assist with all aspects of the medication refill process using established guidelines to facilitate authorization of medication refills for clinic patients.
• Effectively receive prescription refills request via fax, e-prescription or phone and process requests in a timely manner utilizing the electronic health record (EHR) and in accordance with protocol and all NLH Policies and procedures.
• Complete prior authorizations via third party applications and communicate to practice staff in an efficient and timely manner.
• Demonstrate flexibility and teamwork by accepting changes to daily work assignments based on coverage needs and volume.
• Escalate requests to prescriber and/or office staff when request requires extensive clinical review or denial.
• Coordinate scheduling of visits and labs as directed by protocol, provider or the pharmacist.
• Appropriately triage phone calls and voicemails from pharmacies, patients and providers.
• Troubleshoot patient and provider questions and concerns, referring to Manager as appropriate.
• Provide high quality customer service to patients, family members and care team members.
• Sign work from home agreement and adhere to NLH's work from home policy. Understand that work from home authorization may be revoked by the Manager if conduct or productivity standards are not met.
• May be required to work in-person from a business worksite for additional in-person training sessions or "go-live" events at the discretion of the Manager.
• Other duties as assigned.

Qualifications

• Demonstrates Adaptability
• Demonstrates Emotional Intelligence
• Effectively Communicates
• Exercises Sound Judgment & Decision Making
• Serves Others
• Behaves with Integrity and Builds Trust
• Cultivates Respect
• Fosters Accountability
• Practices Compassion

Education

• Required High School Diploma/General Educational Development (GED)

Working Conditions

Questions? Contact Talent Acquisition:

• Phone: 207-973-7100
• Email: [email protected]