Pharmacy Prior Authorization Representative:
Accredo Health Group Inc

1414193559
Accredo Health Group Inc
Medical Device
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Description
Review requests from doctors, providers and pharmacists to determine whether medication coverage prior authorization can be given by screening and reviewing requests based on Medical benefit plan design, client specifics and clinical criteria.

This role is Work from Home which allows most work to be performed at home or on occasion at a Cigna office location. Employees must be fully vaccinated if they choose to come onsite.

ESSENTIAL FUNCTIONS
  • Handle inbound telephone and written inquiries from providers and doctor's offices regarding prior authorization by screening and reviewing requests based on Medical benefit plan design, client specifics and clinical criteria.
  • Provide information to clients, participants, pharmacists and doctors regarding participant's Medical benefit, drug coverage and provide accurate procedures for medication exceptions.
  • Facilitate resolution of Medical drug coverage issues and pro-actively address, research and resolve issues while maintaining accurate and complete documentation of all inquiries for continuous improvement.
  • Work collaboratively with other associates and supervisor to ensure that best practices are shared.
  • Willingness to work Monday through Friday any shift between the hours of operations 8am to 7pm with rotating Saturdays
  • Other tasks or projects as assigned.


QUALIFICATIONS
  • High school diploma or equivalent
  • One to two years' experience in a call center environment preferred
  • Proficient written and oral communication skills
  • Pharmacy experience helpful
  • Strong interpersonal skills and conflict resolution. S
  • Strong data entry, 10-key skills, and basic computer skills.
  • Self-motivated with ability to work in a fast-paced production environment.
  • Ability to adapt in a dynamic work environment and make decisions with minimal supervision.
  • Must be a current contractor with Cigna, Express Scripts, or Evernorth. Evernorth is a new business within the Cigna Corporation.


This position is not eligible to be performed in Colorado.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.