Prior Authorization Specialist
Nurx is looking for a Prior Authorization Specialist who is driven by our mission of putting our patients in control of their own healthcare. We are adding key players to our team who are empathetic, upbeat, proactive, and organized when responding to our patient’s needs.
Nurx is on a mission to change the way healthcare is delivered, making it more accessible and affordable for patients, nationwide. With a specialty in sensitive health, we have built the industry-leading telehealth platform that spans consultation, diagnoses and fulfillment (right to your door). We are committed to revolutionizing the healthcare industry and that’s where you come in!
Today we have more than 275,000 patients, are growing 90% year-over-year, and operate in 30 states. We are lucky to count Kleiner Perkins and Union Square Ventures as investors and Chelsea Clinton and Regina Benjamin as Board Members.
What You Can Expect
- Prioritize incoming prior authorization requests according to urgency.
- Triage prior authorization rejections to determine validity of the prior authorization.
- Communicate with patients regarding clinical information to be used when submitting the prior authorization.
- Review patient chart documentation to ensure accuracy of prior authorization submissions.
- Request, track and obtain prior authorization from insurance carriers within time allotted for medical and services using my meds, fax or verbal communication.
- Follow up on prior authorizations that have been submitted with no response from the insurance carrier in a timely manner.
- Initiate appeals for denied authorizations, when justifiable.
- Maintain patient files on PA tracker.
- Compose letters for various situations to include medical necessity letters, PrEP letters and appeal letters.
- Use ICD-10 diagnosis codes accurately and properly in the submission of prior authorizations.
- Contact patients via the platform to update the status of their prior authorization.
- Assist patients with medication assistance programs to include, obtaining signatures from providers, submit documentation to medical assistance programs and tracking progress.
- Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
- Communicate with pharmacies, insurance carriers via phone, fax or written communication.
- Maintain a level of productivity suitable for the department.
- Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
- Other duties as assigned.
- 2 years of experience in a medical office working with prior authorizations.
- Ability to evaluate options and make efficient decisions.
- Organizational skills sufficient to maintain consistently accurate records.
- Computer skills that include proficiency with multiple programs and use of the internet and email.
- Remote role - but primary residence must be in Florida, Colorado, Ohio, New York, Georgia, Texas, Washington, or Massachusetts
- Full time, to include weekend shifts
We believe healthcare should be unconditional. It doesn’t matter who you are or what you get up to in your own time. You deserve to be treated quickly and with compassion. That’s why we’re pioneering a new type of healthcare that’s easier and smarter, one in which vital medications and tests are accessible and affordable to everyone. No ifs, no buts. Nurx is built to deliver on the three things everyone needs from their healthcare. Choice, so you can make positive decisions about your own body. Control, so you can plan ahead and look after yourself without complication. And freedom, so your access to medication is never blocked by cost, bureaucracy, geography, stigma, or anything else. The Nurx team is composed of world class physicians, business leaders, and industry experts. Together we're working to make healthcare more accessible and simpler for everyone.
This position is full-time and remote position.