TwelveStone Health Partners is focused on the medication needs of patients with chronic, complex and rare conditions. For more than 35 years, TwelveStone Health has been dedicated to finding new ways to deliver care designed around the patient.
TwelveStone Health Partners supports the transition from acute to post-acute care environments and the journey from sickness to health. We are currently licensed in 50 states.
Summary: We are currently hiring for the position of full-time Authorization Specialist II at our corporate office located in Murfreesboro, TN. This position is responsible for obtaining prior authorizations for referrals for the infusion centers.
Essential Duties & Responsibilities
• Responsible for initializing prior medical/pharmacy authorization requests that are assigned. Follow the Prior Authorization Criteria for medications and submits requests. Communicate with insurance companies to pre-certify/authorize medications.
• Obtain clinical information (including but not limited to medical history, diagnosis, and any relevant lab reports) necessary to complete the Prior Authorization. Reviews the clinical information for completeness for insurance requirements and follows up with any questions.
• Handle complex authorization requests and issues as needed.
• Perform duties and job functions in accordance with the policies and procedures established for the department and any other duties as assigned.
The successful candidate will possess the following knowledge, skills and abilities:
• Education: High school diploma or GED required
• Experience: One year related experience and/or training with an healthcare organization, retail, or mail order pharmacy, or PBM. Experience with completing referrals and navigating insurance portals and orders. Experience working in a highly productive department with strong metrics accountability/ownership.
• Functional Competencies: Attention to detail, critical thinking, problem solving, approachable, phone etiquette, dependable, verbal and written communication, teamwork, cooperation, collaboration, judgment, initiative, follow-through, Ability to prioritize and multi-task when presented with multiple duties, Self-starter with the ability to work independently and as part of a team.
...individuals who thrive on making an impact and want the excitement of being on a team that wins.**Job Description****Summary**Field Service Engineers perform routine and complex work related to the calibration and maintenance of process and laboratory equipment and...
GUARDIAN ANGEL SENIOR SERVICES is looking for a compassionate Caregiver to join our team in the multiple locations for both shorter & longer hours. The Caregiver is responsible for the physical care and emotional support to our clients with the difficulty to take ...
Optum CA is seeking a Family Medicine Physician to join our Primary Care team in Colton, CA . Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, youll be an integral part of...
...Put your Insurance Experience to work FROM HOME! At WAHVE , we value... ...REQUIRE ~25 years of full-time work experience ~10 most recent... ...A WAHVE VINTAGE EXPERT ~ Health insurance based on eligibility... ...Customize your schedule full or part time . ~ Utilize your years...
...To help us keep the mission on track were looking for a Community Manager to help us grow a mission-aligned network in a key region... ...~ Sourcing and onboarding prospect pros. ~ Both online outreach and via partnerships + events. ~ Measured against onboarded...