About this opportunity
A-Line Staffing Solutions lists this *Representative I, Clinical Services opportunity in woonsocket, Rhode Island. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Job Title: Representative I, Clinical Services Address: RI, US Job Description Handle inbound calls from providers, pharmacies, and members, providing courteous assistance through the prior authorization process. Maintain complete, timely, and accurate documentation of reviews and clinical interactions. Transfer clinical questions, escalations, and judgment calls to the pharmacist team. Assist with outbound calls, reviewing and processing Prior Auths received via fax and ePA. Monitor and respond to inquiries via department mailboxes and other tasks as assigned by leadership. Ensure compliance with HIPAA and company policies in all interactions. Critical Information Remote work; fully remote with a private, distraction-free workspace. Work hours: starting from 8am to 11pm EST; training scheduled from 8am to 4:30pm EST, with post-training flexibility. Must have a hardwired internet connection with minimum 25 Mbps download and 3 Mbps upload speeds. Ability to work on a computer for the duration of shift; smartphone required for PING application. No time off allowed during training period; shifts and schedules may vary post-training. Education/Licenses Needed High School diploma or GED required. Prior authorization experience and healthcare industry knowledge are preferred. Benefits: Benefits are available to full-time employees after 90 days of employment. A 401(k) with company match is available after 1 year of service. This is an AI-formatted job description; recruiter confirmation required.
Worksite address
woonsocket, RI, 02895, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.