Clinical Services Clerk

Job description

Overview Scope of Responsibilities: Assist with the day-to-day operations of the clinical department of ProAct. Works under direct supervision and follows standard procedures to accomplish assigned tasks. Job Summary: Responsibility for assisting with the prior authorization process and with tasks to meet the clinical needs of ProAct clients and members. Works closely with Clinical Services Specialist to prioritize tasks and responsibilities. Responsibilities: Job Duties: - Assist in preparation, organization, and communication regarding prior authorization requests. - Provide Help Desk support, where appropriate, for questions regarding overrides or clinical system edits. - Responsible for working with Implementation Department for loading prior authorization data for new clients when appropriate. - Assist in preparation of member mailings for various cost containment/clinical programs. - Assist in finding most cost-effective channels for specialty medications and being sure medications are being filled through proper network channels. - Assist in the preparation, where appropriate, of reports or records of prior authorization activity including invoicing documents for client bill...