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Amerita
Prior Authorization Specialist / Remote
Career Insights for Medical Claims Processor / Representative
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What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$39,219 / year median in the U.S.
-5% projected decline
Job Description
Our Company Amerita Overview This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process.
Schedule:
Monday - Friday 9:30am - 6:30pmCST We Offer:
- Competitive Pay
- Health, Dental, Vision & Life Insurance
- Company-Paid Short & Long-Term Disability
- Flexible Schedules & Paid Time Off
- Tuition Reimbursement
- Employee Discount Program & DailyPay
- 401k
- Pet Insurance Responsibilities Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply, ensuring compliance with payer requirements and clinical guidelines.