[Remote] Coverage Determination (Prior Authorization)

Remote, USA Full-time
Note: The job is a remote job and is open to candidates in USA. LanceSoft Inc. is seeking an Intake Specialist to assist with the prior authorization process by handling inbound calls and providing professional phone assistance. The role involves maintaining accurate documentation, managing work volume, and ensuring compliance with various requirements while communicating with internal groups regarding determination status. Responsibilities • Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards. • Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers. • Communication with other internal groups regarding determination status and results (nurses, pharmacists, etc). Skills • 0-3 years of related work experience. • Prior authorization experience / knowledge. • Data entry. • Customer service. • Good written and verbal skills needed. • Good phone manner. • Ability to sit for long periods of time. • Strong Attention to detail. • Excellent verbal and written communication and interpersonal skills w/ ability to maintain patient confidentiality. • Proficient computer skills and the ability to navigate in a Windows based environment. • Ability to follow directions, and adapt in dynamic work environment. • Ability to adapt to change and remain flexible. • Ability to work in a high pressure, time sensitive environment. • Project a professional business image, through phone interaction as well as internal communications. • Demonstrated problem-solving ability and attention to detail. • Demonstrated sense of urgency with assignments. • Strong organizational skills. • Strong telephone skills. • Ability to read and understand pharmacy/medical terminology. • Ability to read, analyze and interpret general business correspondence, technical procedures and governmental regulations. • Ability to identify and solve practical problems and deal with a variety of concrete variables in standardized situations. • Ability to perform basic mathematic calculations maybe required. • Ability to interpret a variety of work instructions provided through a variety of mediums. • Ability to anticipate needs and resolve issues with urgency. • Ability to consistently meet quality and production standards. • Displays confidence in the ability to learn complex material. • Demonstrates intellectual curiosity through inquiries to ensure deep understanding of the business and deliver accurate results. Education Requirements • High School Diploma or GED required. Company Overview • Established in 2000, LanceSoft is a pioneer in delivering top-notch Global Workforce Solutions and IT Services to a diverse clientele. It was founded in 2000, and is headquartered in Herndon, Virginia, US, with a workforce of 5001-10000 employees. Its website is Company H1B Sponsorship • LanceSoft Inc., has a track record of offering H1B sponsorships, with 11 in 2025, 32 in 2024, 23 in 2023, 25 in 2022, 60 in 2021, 80 in 2020. Please note that this does not guarantee sponsorship for this specific role. Apply tot his job
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