Prior Authorization Coordinator – Bilingual

  • Company:
  • Location:
  • Salary:
    negotiable / monthly
  • Job type:
  • Posted:
    1 month ago
  • Category:
    Health Care

This position is suited to an individual who works well both independently and as part of a team, in an environment that is constantly changing. The Prior Authorization Coordinator,(Bilingual – French and English), Drug Services is responsible for assessing coverage of drugs that require prior authorization before allowing coverage under a group drug plan. The incumbent reviews medical information based on guidelines in place, and in consultation with the Medical Board must determine if coverage can be approved or declined. Once the decision is made, they must communicate the results both verbally and in writing to the plan member.Accountabilities:Review medical information submitted by the patient’s physician to determine if all of the necessary information has been received in order to complete the assessment. If not, must correspond with either the plan member or the physician to obtain any missing information.Determine, based on the group plan parameters, if coverage is eligible under the group plan.Review the medical information and determine if further investigation with the Medical Board is required or if the assessment can be made based on the information available to you.Correspond both by phone and in writing with plan members to advise and support the decisions made.Provide support to the Great-West Life Group Offices, Sales & Marketing Centers, Benefit Payment Offices, and Group Customer Contact Services regarding prior authorizations.Qualifications and Competencies:Post-secondary degree with preference to those in a related field such as Pharmacy Technician,Medical Transcriptionist and/or Medical Secretary or related experience or combination of education and experienceAbility to deliver high quality results with speed and accuracy in a fast paced challenging and ever changing work environmentStrong organizational, quality and time management skillsExcellent analytical, investigative and problem solving skillsStrong customer service skillsExcellent verbal and written communication skillsExperience working in Excel, Word and Access. Excellent keyboarding skills of 40wpmAt ease navigating through multiple computer programs simultaneouslyKnowledge of the insurance industry and exposure to drug plans will be considered an assetKnowledge of internal systems (BEN, TOCs, TSO and Cybrary) will be considered an assetLiving our values of Customer View; Integrity; Partnership; and CommunitiesDiscover your opportunity….Apply today!Great-West Life offers competitive compensation, great benefits such as medical, dental, life insurance, wellness account and personal days not to mention onsite cafeteria and fitness facilities. If you’d like to join our team submit your information online and introduce yourself.Together Great-West Life, London Life and Canada Life serve the financial security needs of more than 13 million people across Canada, with additional operations in Europe and the United States. As members of the Power Financial Corporation group of companies, we’re one of Canada’s leading insurers with interests in life insurance, health insurance, investment and retirement savings. We offer a broad portfolio of financial and benefit plan solutions for individuals, families, businesses and organizations.We are committed to providing an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential.Great-West Lifeco would like to thank all applicants, however only those who qualify for an interview will be contacted.