Experienced Customer Service Representative – Remote Prior Authorization Specialist for Pharmacy Operations and Healthcare Services

Introduction to arenaflex Imagine being part of a dynamic team that is revolutionizing the healthcare industry by making it more affordable, personalized, and focused on the well-being of the whole person. At arenaflex, we are dedicated to improving the health and vitality of those we serve. Our mission is to drive growth and enhance the lives of our clients, customers, and patients through our innovative services and commitment to excellence. If your dream job involves working from home and helping others, we have an exciting opportunity for you to join our team as a Customer Service Representative – Remote Prior Authorization Specialist. About the Role In this pivotal role, you will be responsible for responding to phone inquiries from healthcare professionals and assisting them with the medication prior authorization process. As a Prior Authorization Representative, you will be part of a dedicated team that provides information regarding pharmacy benefits and drug coverage. Your primary goal will be to deliver straightforward administrative and other basic business services in Pharmacy Operations, ensuring that healthcare professionals receive accurate and timely information to provide the best possible care for their patients. Key Responsibilities Collection of structured clinical data for prior authorization and non-formulary exception requests, following the guidance provided in our online prior authorization tools and corresponding forms. Initial screening of requests based on guidance given by online prior authorization tools. Approving prior authorization requests if the data collected meets the approval specifications. Referring prior authorization requests that do not meet the approval specifications to a clinician for review. Independently responding to contacts ranging from routine to moderate complexity, and seeking assistance from healthcare professionals for service issues of substantial complexity. Performing research to respond to inquiries and interpreting policy provisions to determine the most effective response using established departmental procedures, HIPAA regulations, and corporate policies. Qualifications and Skills To be successful in this role, you will need to possess excellent customer service skills, with the ability to interact effectively and efficiently with healthcare professionals using excellent interpersonal and listening skills, critical thinking, and problem-solving skills. You should be confident in your ability to educate and provide accurate responses to inquiries, and be able to multitask and use computer-based resources effectively. Essential Qualifications High School Diploma or GED. 1+ years of call center experience. Prior work from home experience. Prior medical or pharmacy knowledge is an asset. Reliable high-speed broadband internet, hard-wired connection, with speeds of at least 10 Mbps for download and 5 Mbps for upload. Quiet and private space designated for work without interruption. Excellent customer service, interpersonal communication, attention to detail, and critical thinking skills. Excellent computer skills, with familiarity with Microsoft Office and a working knowledge of the Windows operating system. Tech-savvy, with the ability to easily navigate across multiple screens and applications. Preferred Qualifications Experience working in a healthcare or pharmacy environment. Knowledge of prior authorization processes and procedures. Experience with electronic health records and other healthcare software applications. Bilingual or multilingual skills. Career Growth and Learning Benefits At arenaflex, we are committed to the growth and development of our employees. As a Customer Service Representative – Remote Prior Authorization Specialist, you will have access to comprehensive training programs, ongoing coaching and feedback, and opportunities for career advancement. You will be part of a dynamic team that is passionate about delivering exceptional customer service and making a positive impact on the lives of our clients and patients. Work Environment and Company Culture At arenaflex, we pride ourselves on our positive and inclusive work environment. We believe in fostering a culture of respect, empathy, and open communication, where every employee feels valued and supported. As a remote worker, you will be part of a virtual team that is connected through technology and shared goals. We offer a range of benefits and perks to support your well-being and work-life balance, including flexible scheduling, paid time off, and access to employee assistance programs. Compensation and Benefits We offer a competitive compensation package, including a salary range that reflects your experience and qualifications. You will also be eligible for a range of benefits, including health, dental, and vision insurance, 401(k) matching, and paid time off. We believe in recognizing and rewarding our employees for their hard work and contributions, and offer opportunities for bonuses and incentives. Conclusion If you are a motivated and customer-focused individual who is passionate about delivering exceptional service and making a positive impact on the lives of others, we encourage you to apply for this exciting opportunity. As a Customer Service Representative – Remote Prior Authorization Specialist at arenaflex, you will be part of a dynamic team that is dedicated to improving the health and vitality of those we serve. Don't miss out on this chance to join our team and start making a difference today! Apply for this job