Prior Authorization Specialist

About Us

Nurx is transforming healthcare by delivering convenient, affordable, and personalized care that empowers patients and improves health outcomes. The leader in digital healthcare for women, Nurx combines medical providers who are passionate about patient care with cutting-edge tech solutions to offer asynchronous medical consultations and home delivery of medication and tests. We’ve provided birth control, prescription skincare, migraine treatment, PrEP, herpes medication, STI testing and more to more than 1 million patients, and we’re just getting started. 

We are lucky to count Kleiner Perkins and Union Square Ventures as investors and Chelsea Clinton and former US Surgeon General Regina Benjamin as board members. We’re on a mission to make every part of getting healthy and staying healthy, better — and we’re looking for people like you to help!

Nurx is looking for a Prior Authorization Specialist who is driven by our mission of putting our patients in control of their own healthcare. We are adding key players to our team who are empathetic, upbeat, proactive, and organized when responding to our patient’s needs. 

 What You Can Expect

• Prioritize incoming prior authorization requests according to urgency.
• Triage prior authorization rejections to determine validity of the prior authorization.
• Communicate with patients regarding clinical information to be used when submitting the prior authorization.
• Review patient chart documentation to ensure accuracy of prior authorization submissions.
• Request, track and obtain prior authorization from insurance carriers within time allotted for medical and services using my meds, fax or verbal communication.
• Follow up on prior authorizations that have been submitted with no response from the insurance carrier in a timely manner.
• Initiate appeals for denied authorizations, when justifiable.
• Maintain patient files on PA tracker.
• Compose letters for various situations to include medical necessity letters, PrEP letters and appeal letters.
• Use ICD-10 diagnosis codes accurately and properly in the submission of prior authorizations.
• Contact patients via the platform to update the status of their prior authorization.
• Assist patients with medication assistance programs to include, obtaining signatures from providers, submit documentation to medical assistance programs and tracking progress.
• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
• Communicate with pharmacies, insurance carriers via phone, fax or written communication.
• Maintain a level of productivity suitable for the department.
• Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
• Other duties as assigned.

Minimum Qualifications

• 2 years of experience in a medical office working with prior authorizations.
• Ability to evaluate options and make efficient decisions.
• Organizational skills sufficient to maintain consistently accurate records.
• Computer skills that include proficiency with multiple programs and use of the internet and email. 
• Remote role - but primary residence must be in Florida, Colorado, Ohio, New York, Georgia, Texas, Washington, or Massachusetts

Schedule 

• Full time, to include weekend shifts 

This position is full-time and remote position.