Pharmacy Prior Authorization Agent Atrium Health Home Infusion

**Department:** 10010 AH at Home: Infusion \- Administration **Status:** Full time **Benefits Eligible:** Yes **Hou****rs Per Week:** 40 **Schedule Details/Additional Information:** M\-F 8:30\-5 **Pay Range:** $22\.90 \- $34\.35**Major Responsibilities:** * Complete insurance verification and eligibility checks. * Collect and accurately document initial pre\-certification/authorization information if available. Initiates the process of obtaining a required referral/authorization if not obtained. * Work assigned Epic work queue, following the department’s workflow process on appropriately transferring, deferring, or removing orders from the work queue. * Proactively communicate issues involving customer service and process improvement opportunities to management. * Maintains excellent public relations with patients, patients’ families and clinical staff as well as demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information. * Maintains knowledge of and reference materials for Medicare, Medicaid and third\-party payer requirements guidelines and policies, insurance plans requiring pre\-authorization/referral and a list of current accepted insurance plans. * Update the patient, physician's office, and any necessary parties, through multiple methods as appropriate (including telephone, in\-basket messaging, and electronic medical record), regarding responses and outcomes of the prior authorizations. * Act as a liaison between physician's office, patient, and pharmacy benefit manager to initiate and resolve appeals, as needed. * May identify and assist patients with access to internal and external financial assistance programs. * May communicate to the patient and/or physician's office when authorization is not obtained, or services are not covered, and explains the potential financial responsibility. Coordinates with patient, clinical team, and assistance programs to secure reimbursement or alternat