MedOne Healthcare Systems is a national, full-service transparent pharmacy benefit administrator headquartered in Dubuque, Iowa and licensed as a third-party administrator (TPA) by the State of Iowa. We are an innovative and fast-paced company looking for employees interested in working for a business where they can make a difference. MedOne is committed to building solutions with the most current technologies available in the market place. We operate in a fast-growing industry that supports significant business growth and as a result, wonderful growth opportunities for our employees.
The ideal candidate will be a self-starter, who is detail-oriented and accurate in their day-to-day work. This candidate should be culture-focused, bringing enthusiasm to the office and offering up new ideas and programs. This candidate should also have experience with a variety of office software (email tools, spreadsheets and databases).
Essential Job Functions
- Support operations of MedOne Clinical Services
- Initiate Prior Authorization requests
- Review incoming Prior Authorization documentation for completeness
- Prepare clinical review documentation for review by a MedOne Clinical Pharmacist
- Communicate clinical review decision to pharmacies and providers
- File completed Prior Authorization documentation
- Enter Clinical Review determination into the claims processing system(s)
- Communicate the status of Clinical Reviews with patients
- Schedule Clinical Review Denial Calls with a Clinical Pharmacist
- Update Clinical Authorization Criteria and Clinical Review Request Forms under the direction of a Clinical Pharmacist
- Work well in a team environment
- Supports operations of MedOne Pharmacy Services as needed
- Assists and supports members of MedOne Healthcare Systems
- Portrays the company in a positive image
- Required to abide by all rules, regulations and policies of the employer
Work Hours
- Full time (greater than 30 hours per week), non-exempt
Required Experience & Skills
- Must be detail-oriented and precise
- Must have excellent interpersonal, written, and verbal skills
- Strong customer service and teamwork skills
- Must have a strong understanding of Microsoft Office (Word, Excel, PowerPoint)
- Must be able to type at a minimum of 30 words per minute
- Must be able to work independently, meets deadlines, establish priorities, and be flexible.
- Must be able to stand/sit for long periods of time within limited space
- Must be able to lift up to 25 pounds
- Must be able to work cooperatively with MedOne Healthcare Systems staff
NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties to meet the ongoing needs of the organization.
Equal Opportunity Employer (EOE)
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Job Details
Req Num | -- |
ID | 499071 |
Location |
Dubuque, IA
|
Positions | 1 |
Type | Employee |
Status | Full Time |
Pay | -- |
Categories |
Clerical/Office Administration
Customer Service
Health Care
Pharmacy
Technical
|
Benefits |
Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Paid Vacation
Paid Holidays
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Preferred Candidates
Years of Experience | -- |
Education | -- |