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Remote Prior Authorization Representative Express Scripts Jobs in Georgia

InsuraTec

Sales Representative (Remote)

Fairburn, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Suwanee, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Perry, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Atlanta, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Kingsland, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Rincon, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Woodstock, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Pooler, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Martinez, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Dublin, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Redan, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Conyers, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Roswell, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

InsuraTec

Sales Representative (Remote)

Kennesaw, GA · Remote

We're looking for driven individuals to join our team as Sales Representatives in a fully remote ... No prior experience needed; we offer full training. * Self-Motivated : Must be highly driven and ...

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All JobsPrior Authorization Representative Express Scripts JobsRemote Prior Authorization Representative Express Scripts JobsRemote Prior Authorization Representative Express Scripts Jobs in Georgia

Remote Prior Authorization Representative Express Scripts information

What is the difference between Remote Prior Authorization Representative Express Scripts vs Remote Claims Processor?

AspectRemote Prior Authorization Representative Express ScriptsRemote Claims Processor
CredentialsHigh school diploma, healthcare certifications often preferredHigh school diploma, healthcare or insurance certifications
Work EnvironmentRemote, healthcare insurance settingRemote, insurance claims processing environment
Employer & IndustryExpress Scripts, healthcare/pharmacy industryVarious insurance companies, healthcare industry
Primary ResponsibilitiesReview and approve prior authorization requestsReview and process insurance claims

The Remote Prior Authorization Representative at Express Scripts focuses on evaluating and approving prior authorization requests for medications, ensuring timely patient access. In contrast, a Remote Claims Processor handles the review and processing of insurance claims after services are rendered. While both roles require healthcare knowledge and remote work skills, their core functions differ in the stages of the insurance process they manage.

What are popular job titles related to Remote Prior Authorization Representative Express Scripts jobs in Georgia? For Remote Prior Authorization Representative Express Scripts jobs in Georgia, the most frequently searched job titles are:
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Remote Prior Authorization Representative Express Scripts jobs near you
Scheduling and Authorization Coordinator

Scheduling and Authorization Coordinator

Elevate Patient Financial Solutions

Waycross, GA • Remote

$17 - $22.75/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago

Elevate Patient Financial Solutions rating

8.4

Company rating: 8.4 out of 10

Based on 27 frontline employees who took The Breakroom Quiz

Job description

Elevate Patient Financial Solutions has an exciting career opportunity available as a Scheduling and Authorization Coordinator. This remote position requires the individual to live within a 2-hour radius of Waycross, GA. The Full-Time schedule for this role will be ­­­­­­­­­­­­­­­­Monday-Friday 8:00am-5:00 pm EST.
Job Summary
The Scheduling and Authorization Coordinator delivers exceptional customer service when communicating with patients over the phone to provide the necessary information for applicable scheduling and imaging. They request information related to the coordination and scheduling of diagnostic imaging and other procedures and treatments for hospitals contracted with ElevatePFS®. The Scheduling and Authorization Coordinator interacts directly with the patients, referring physicians, Hospital Services
, and internal company associates to guarantee smooth coordination of procedures and exams.
Essential Duties and Responsibilities
Insurance Authorization/Verification
  • Thoroughly completes the insurance verification process to ensure the accuracy of insurance information.
  • Obtains insurance authorizations, referral, and treatment consults as needed for all scheduled patients prior to receiving services.
  • Obtains benefit coverage from insurance companies and accurately enters information into the appropriate computer system.
  • Obtains diagnosis information and/or CPT code from the physician/office or the outpatient department, as necessary for completing the insurance authorization process.
  • Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs.
  • Monitors appropriate work lists to ensure timely insurance verification processing.
  • Maintains documentation necessary for compliance with state, federal, and other regulatory agency requirements.
  • Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs.
Scheduling
  • Schedules all types of complex exams with attention to detail.
  • Ability to manage high outbound and inbound calls to schedule patients for imaging services to ensure the best possible customer service by properly educating the patient on exam preparation and answering questions.
  • Screens and verifies all HIPPA information to ensure accuracy with scheduling and speaking with patients, patients approved representatives and or physicians.
  • Schedules and documents notes in hospital and ElevatePFS® operating systems.
Clerical
  • Monitors and manages the e-mail inbox or fax machine for assigned practices throughout the day.
  • Works any requests received via e-mailed or fax.
  • Checks and responds to voicemails.
  • Creates, maintains and monitors log of patients and procedures scheduled for assigned physician practices.
  • Monitors appropriate work lists to ensure timely insurance verification processing.
  • Utilizes multiple commuter application, scheduling software, network, drives to schedule multiple exams within multiple modalities and entities across the hospitals system.
Additional Responsibilities
  • Effectively communicates operational activities and issues with Supervisor and Manager.
  • Interfaces courteously and effectively with internal and external customers. Must consistently present a positive departmental and organizational image, as well as commitment to departmental goals, objectives, standards, policies and procedures.
  • Demonstrates proficiency within assigned area of responsibility and a general understanding of the entire Patient Access process.
  • Adheres to the hospitals and until level policies and procedures and safeguards set forth by each facility.
  • Identifies and recommends process improvements for RMA services.
  • Other duties as assigned.
Qualifications and Requirements
  • High school diploma or GED
  • Associate degree or 2+ years in patient scheduling, registration, or healthcare billing is preferred
  • Over one (1) year working in a customer service or client relations type role
  • Office or hospital environment experience is preferred
  • High volume call center experience is preferred
  • Strong Literacy (grammar, spelling, math)
  • Strong Microsoft Products experience, including word, excel, outlook, windows
  • Familiarity with HCA/Parallon IT systems is preferred
  • Strong sales and customer service skills
  • Excellent interviewing and telephone communication skills
  • Outstanding interpersonal and people‑oriented skills
  • Excellent written and verbal communication abilities
  • Ability to communicate assertively and professionally while maintaining confidence and credibility.
  • Strong analytical, problem‑solving, and decision‑making skills
  • High level of organization, attention to detail, and time management
  • Ability to multitask and prioritize effectively in a fast‑paced environment
  • Proven ability to work independently with minimal supervision
  • Strong stress management and adaptability skills
  • Goal‑driven with a strong action and results orientation
  • Demonstrates initiative, persistence, and a strong work ethic
  • Team‑oriented with the ability to collaborate effectively
  • Flexible and adaptable to changing priorities
  • High standards of honesty, integrity, and professionalism
  • Profit‑ and performance‑oriented mindset
  • Remote and hybrid positions require internet connectivity that meet the Company’s upload and download requirements.

Benefits
ElevatePFS believes in making a positive impact not only within our industry but also with our employees –the organization’s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.
  • Medical, Dental amp; Vision Insurance
  • 401K (100% match for the first 3% amp; 50% match for the next 2%)
  • 15 days of PTO
  • 7 paid Holidays
  • 2 Floating holidays
  • 1 Elevate Day (floating holiday)
  • Pet Insurance
  • Employee referral bonus program
  • Teamwork: We believe in teamwork and having fun together
  • Career Growth: Gain great experience to promote to higher roles
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.
The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Elevate, PFS is an Equal Opportunity Employer

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