Remote Medicare Authorization Representative

Job Summary

Working remotely, the full-time Representative I will review fax documents, create Medicare Prior Authorization case reviews using multiple software systems, and ensure compliance with government-mandated timelines.

Key responsibilities

• Review and forward fax documents to appropriate queues accurately
• Document Coverage Determination/Appeal requests and escalate issues as needed
• Maintain knowledge of Medicare D guidance and participate in developmental discussions with supervisors

Required qualifications

• High School diploma or GED verified
• Pharmacy or medical background preferred but not required
• Experience working independently preferred