What are the responsibilities and job description for the Authorization Representative I position at CareBridge?
Be Part of an Extraordinary Team
BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that's easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer's treatment journey.
Build the Possibilities. Make an extraordinary impact.
Title: Authorization Representative I
Location: 370-774 Northlake BLVD, Altamonte Springs, FL
Elevance Health supports a hybrid workplace model with Pulse Points (offices) used for collaboration, community and connection. The hybrid schedule for this position is determined by team needs and generally consists of 2-3 days a week onsite. Traditional business hours are observed and align with the Eastern or Central time zones. Candidates must reside within 50 miles or 1-hour commute each way of the Elevance Health location listed above.
Shift: Monday - Friday; 10:00am-7:00pm
The Authorization Representative I is responsible for the completion and submission of appropriate forms for patients whose health plan requires drug prior authorizations and re-authorizations for different therapy types.
How you will make an impact
Primary Duties May Include, But Are Not Limited To
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that's easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer's treatment journey.
Build the Possibilities. Make an extraordinary impact.
Title: Authorization Representative I
Location: 370-774 Northlake BLVD, Altamonte Springs, FL
Elevance Health supports a hybrid workplace model with Pulse Points (offices) used for collaboration, community and connection. The hybrid schedule for this position is determined by team needs and generally consists of 2-3 days a week onsite. Traditional business hours are observed and align with the Eastern or Central time zones. Candidates must reside within 50 miles or 1-hour commute each way of the Elevance Health location listed above.
Shift: Monday - Friday; 10:00am-7:00pm
The Authorization Representative I is responsible for the completion and submission of appropriate forms for patients whose health plan requires drug prior authorizations and re-authorizations for different therapy types.
How you will make an impact
Primary Duties May Include, But Are Not Limited To
- Enters prior authorizations and re-authorizations into the portal and ensures accurate completion of re-authorization forms.
- Submits completed prior authorizations and re-authorization forms to the appropriate insurance plans.
- Maintains log of all prior authorizations and re-authorizations submitted.
- Follows up with the patient's insurance company or physician office by phone, email or spreadsheets on all submitted prior authorizations and re-authorization for patient approval/denial status.
- Requires a HS diploma or GED and a minimum of 1 year of experience processing pharmacy prior authorizations; or any combination of education and experience which would provide an equivalent background.
- Prior Authorization experience preferred.
- Cover My Meds and Enterprise RX experience preferred.
- Claims rejection processing experience preferred.
- Specialty Pharmacy experience preferred.
- Specialty Medication experience preferred.
- Direct experience with insurance companies preferred.
- Adaptability to change and work in a high paced environment preferred.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
