0523 Medical Care Review Technician

Location: Phoenix, AZ, United States
Date Posted: 01-11-2018
Core Responsibilities:
  • Review and process Coverage Determination cases from a queue
  • Review and apply prior authorization criteria for medications, where applicable
  • Make decisions on coverage determination requests based on defined criteria within the scope of approved protocols or decision trees
  • Enter and document coverage determination request decision into the supported database system
  • Notify physicians, providers and members of coverage determination request decisions
  • Meet production requirements
Experience:
  • 1-3 years of healthcare experience, with Pharmacy benefit experience a plus!
  • 1-3 years of experience working with Medicare Part D plans, prior authorizations and/or coverage determination is preferred.
  • Strong computer skills with ability to navigate multiple software systems simultaneously
  • Adhere to and reinforce departmental standard operating procedures and training guidelines specific to HIPPA
  • Strong communication skills with focus on professional demeanor and empathy
  • Excellent problem solving, goal-oriented and deadline driven
  • Flexible with work schedules

Regards,
Renuka Krishnaswamy
Technical Recruiter
ReqRoute,Inc

Desk: 408-800-4331 (PST);
Email: renuka@reqroute.com
Website: http://www.reqrouteinc.com/careers
Companies across U.S. have engaged ReqRoute, Inc to deliver skilled, dedicated IT professionals. Recruiting is our passion and we support Fortune 1000 companies with their hiring needs. We always seek to deliver competitive and sought-after career opportunities to our potential consultants and employees. We invite you to review the position requirements and apply today if your skills match our needs.  
 
ReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law. (www.reqroute.com)
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