MGH Gastroenterology has an opening for a Medication Prior Authorization Specialist. The Medication Prior Authorization Specialist is responsible for obtaining all medication prior authorizations.

Responsible for downloading PA requests and entering into CoverMyMed

Track all other appropriate patient and pharmaceutical information with the goal of accurate information

Will be responsible for resulting out the PA, documenting, and following up on all open PA's not escalated to management

Must be able to communicate effectively with providers and office staff through email and phone calls regarding any issue with the PA process and/or individual patients, such as incomplete information, answering status questions, denials etc

Must be able and willing to call pharmacy, patient, and insurances when needed in order to successfully complete PA'

Must determine which PA's require escalation or further assistance from management

Must complete all necessary training for EHR systems in EPIC

Must possess a working knowledge of pharmacy processe

Must work diligently to assist clinical and administrative teammates within the clinic

Must be pleasant and willing to learn, take direction, ask questions, express needs and communicate effectively in a positive way with all staff

Qualifications

High school diploma or Associates in Science in combination with 2-3 years' experience working with health insurance or in a healthcare setting is essential.

Outstanding customer service, written and verbal communication skills are mandatory.

Ability to prioritize and handle multiple tasks, producing high-quality work in a timely, accurate and efficient manner is required.

Proficiency in the use of computers and basic software applications is necessary.

Ability to be flexible and work within a team-focused, participative management framework is required.

Medication Prior Authorization experience preferred.

EEO Statement

Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.