CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company, to actively engage in problem-solving, and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Acentra is currently looking for a Prior Authorization Reviewer (Remote U.S.) to join our growing team.
Job Summary:
The Prior Authorization Reviewer:
- Reviews verbal and electronic prior authorization requests based upon pre-established criteria and approves or denies authorization.
- Receives incoming calls daily from providers and/or patients seeking assistance.
- Makes outbound calls as needed.
- Enters data project-specific information into the prior authorization processing system.
- Projects a professional company image through written and verbal interaction.
** This is a full-time, non-exempt (hourly) direct hire role with Benefits. **
** The required work Hours are Monday through Friday, 8:30 AM to 5:30 PM Central. **
** The selected candidate must be willing to work rotating shifts, including nights until 7:00 PM Central and some holidays. **
** The selected candidate must have access to high-speed cable internet. **
Job Responsibilities:
- May approve, deny, dismiss/early close, or withdraw prior authorizations of medication according to guidelines as defined by the client.
- Answer incoming calls daily and in a timely manner.
- Assist callers with questions regarding approval or denial of medications.
- Research and resolve issues.
- Document the caller’s questions, issues, and resolution.
- Enter data information into the prior authorization processing system and correct errors as needed.
- Process Requests for Information (RFIs) for client accounts.
- Perform monitoring tasks of the HID/Client database and notify management of errors and/or problems.
- Maintain compliance with all company policies and procedures.
- The selected candidate must be willing to work rotating shifts, including nights until 7:00 PM CT, and some holidays.
- Perform related duties as assigned by supervisor.
- Meet and/or exceed production, quality, attendance, and adherence standards.
- Provide/assist in training other employees.
- Subject to fingerprinting and background screenings as required.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
Required Qualifications/Experience:
- High school diploma OR GED equivalent.
- Active National Certification of Pharmacy Technicians (e.g., PTCB OR ExCPT).
Preferred Qualifications/Experience
- Bachelor’s degree from an accredited college/university.
- 1+ years of retail pharmacy and/or customer contact work experience.
Why us?
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.
We do this through our people.
You will have meaningful work that genuinely improves people’s lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.
Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.
Thank You!
We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!