Sr. Representative, Customer Service Operations (Prior Authorization)

**POSITION SUMMARY**



This role is responsible for processing prior authorization requests efficiently while adhering to payer guidelines and policies.



**ESSENTIAL FUNCTIONS**



**Handles complex prior authorization requests, including high-cost medications and procedures.**



**Serves as a point of contact for escalated authorization issues.**



**Assists in reviewing insurance policies to ensure compliance with payer requirements.**



**Coordinates with healthcare providers and insurance companies to resolve discrepancies.**



**Ensures timely submission and follow-up on authorization requests.**



**Reviews incoming authorization requests and verifies patient eligibility and benefits.**



**Initiates prior authorization requests via phone, fax, or online portals.**



**Tracks and follows up on the status of submi...