REMOTE Benefit Verification Representative Position Available In Allegheny, Pennsylvania

Job Description:

A-Line Staffing is looking for qualified Benefit VerificationRepresentatives or Prior Authorization Representatives for ourPittsburgh location

Benefit Verification Representative Hours:

8 hrshift, Must have availability from 7am to 10pm M-F & work rotatingweekends Sat & Sun7-5:30

Benefit Verification Representative JobDescription:

The Benefit Verification Representative II will workclosely with providers to process prior authorization (PA), anddrug benefit exception requests on behalf of the client and inaccordance with Medicare Part D CMS Regulations. The BenefitVerification Representative Must apply information [providedthrough multiple channels] to the plan criteria defined throughwork instruction. Research and conduct outreach via phone torequesting providers to obtain additional information to processcoverage requests and complete all necessary actions to closecases. Responsible for research and correction of any issues foundin the overall process. Phone assistance is required to initiateand/or resolve coverage requests. Escalate issues to CoverageDeterminations and Appeals clinical pharmacists and management teamas needed. Must maintain compliance at all times with CMS anddepartment standards. Position requires schedule flexibilityincluding rotations through nights, weekend and holidaycoverage.