Overview PHIL is looking for a full-time Prior Authorization Specialist with a focus on pharmacy support for Monday through Friday shifts.
About The Company: Founded in 2015, PHIL is a San Francisco-based Series D health-tech startup, pioneering the first Software Therapy Deployment Platform for Specialty Pharmaceuticals that treat complex health conditions. Our mission is to ensure consistent, reliable and affordable access to complex therapeutics for our patient community. PHIL offers digital patient access services to improve health outcomes by delivering affordable and timely access to high-cost Specialty therapeutics. For more information on PHIL, visit https://phil.us/
Position overview: The most important goal here at PHIL is to improve patients\' medication adherence by offering a quick and effortless way for patients to get their medications on time. Prior Authorization Specialists ensure that prescribing offices have all of the information they need to efficiently complete electronic coverage requests, in addition to providing phone and email support.
Responsibilities Verifies patient insurance coverage utilizing phone or online resources
Submit prior authorizations to insurance plans in a timely manner via electronic portal
Troubleshoots prior authorization submissions and prescription processing with health care providers utilizing phone or online resources
Verbally assist providers in navigating appeals processing
Ensures all pertinent medical documentation is accurate and present prior to authorization submission
Compiles trends in authorization determinations for client and prescriber education
Document activities appropriately in process notes using our operating system
Work closely with our Customer Support team to ensure the success of patients that are recommended to us by their physician\'s office
Qualifications Proven team player, but can solve problems independently as well
Exceptional written and verbal communication skills
Easily adapt to new system and workflow changes
Experience working in prior authorizations, medical insurance billing, and/or health insurance (required)
Working knowledge of ICD-10 codes and prescription drug names (preferred, not required)
Ability to navigate between multiple systems throughout the workday, including operational software and vendor portals
Flexibility to perform duties as volume requires
Customer service experience (preferred)
Access to reliable, high-speed internet to meet remote processing needs (required)
Reliable transportation and ability to work in office as required
Benefits Ground floor opportunity with one of the fastest-growing startups in health-tech
Be part of a company that leverages technology to improve wellness
Full benefits (medical, dental, vision)
401(k) contribution opportunity