Authorization Representative I
Elevance Health

Be Part of an Extraordinary Team

BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that's easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer's treatment journey.

Authorization Representative I

Location: This position will work a hybrid model (1-2 days/week onsite in office). When reporting to the office, the location will be on FL-ALTAMONTE SPRINGS, 370-774 NORTHLAKE BLVD.

Schedule:This position will work within the operational hours of 8:00 am- 7:00 pm 8 hours per day Monday through Friday. Additional hours or days may be required based on operational needs.

The Authorization Representative I is responsible for the completion and submission of appropriate forms for patients whose health plan requires drug re-authorizations for different therapy types.

How you will make an impact.

Primary duties may include, but are not limited to:

• Enters re-authorizations into the portal and ensures accurate completion of re-authorization forms.
• Submits completed re-authorization forms to the appropriate insurance plans.
• Maintains log of all re-authorizations submitted.
• Follows up with the patient's insurance company or physician office by phone, email or spreadsheets on all submitted re-authorization for patient approval/denial status.
• Initiate and process prior authorization requests by gathering necessary documentation and submitting it to insurance providers.
• Address and resolve any issues or delays that arise during the prior authorization process, including, working closely with healthcare providers, and insurance companies to gather necessary information and expedite the authorization process.
• Document all records of prior authorization processes and outcomes, ensuring compliance with regulatory and company standards.

Minimum Requirements:

• Requires a HS diploma or GED and a minimum of 1 year of experience processing pharmacy prior authorizations; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications:

• Specialty pharmacy experience highly preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

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