Prior Authorization Patient Care Advocate

Working at Express Scripts says something about your commitment to quality, your integrity, and desire to excel in your career. Since 1986, many outstanding people have contributed to our success as a Pharmacy Benefits Management leader and Fortune 500 company with over $15 billion in sales. Prior Authorization Patient Care Advocate PRIOR AUTHORIZATION PATIENT CARE ADVOCATEABOUT EXPRESS SCRIPTS:Working Here Says Something About You.  Working at Express Scripts says something about your commitment to quality, your integrity, and desire to excel in your career. Since 1986, many outstanding people have contributed to our success as a Pharmacy Benefits Management leader and Fortune 200 company with over $15 billion in sales. Today, we're looking for more talented people to be an important part of our future and thrive in our progressive and friendly environment that recognizes and rewards achievement.  Express Scripts makes the use of prescription drugs safer and more affordable for more than 50 million people across the United States and Canada. Thousands of managed-care organizations, large employers, insurance carriers, third-party administrators, labor unions, and municipal and state governments rely on the company for innovative solutions to manage pharmacy-benefit costs and enhance their members' quality of care. The Company is headquartered in St. Louis, MO, and maintains major administrative facilities in Bloomington, MN, East Hanover, N.J., and Tempe, AZ.ABOUT THE DEPARTMENT:The Prior Authorization Department is part of the Client & Patient Services organization.  The Client & Patient Services department is responsible for ensuring high-quality service delivery to Express Scripts' members and clients in a cost-efficient manner in the areas of:  Client and benefit administration; Quality control; Client implementation; Eligibility and Prior Authorization.  The Prior Authorization department reviews clinical requests from Doctors and Pharmacists to determine medication coverage. This is a fast paced environment where quality and service excellence matter most.  The ideal candidate would be someone who works with passion in every opportunity and has a commitment to world class service. That is the Express Scripts Way.RESPONSIBILITIES: Review requests from doctors and pharmacists to determine whether medication coverage prior authorization can be given by screening and reviewing requests based on benefit plan design, client specifics and clinical criteria. Handle inbound telephone and written inquiries from pharmacists and doctors regarding prior authorization by screening and reviewing requests based on benefit plan design, client specifics and clinical criteria. Provide information to clients, participants, pharmacists and doctors regarding participants pharmacy benefit, drug coverage and provide accurate procedures for medication exceptions. Facilitate resolution of drug coverage issues and pro-actively address, research and resolve issues while maintaining accurate and complete documentation of all inquires for continuous improvement. Work collaboratively with other associates and supervisor to ensure that best practices are shared. Other special projects as assignedQUALIFICATIONS:High school diploma or equivalent1-2 years experience in a customer service setting, preferably in a call center environmentMedical background Helpful Excellent phone presentation skills and communication skillsDemonstrated ability to handle challenging customers in a professional mannerAbility to adapt in a dynamic work environment, learn quickly, solve problems and make decisions.  General PC knowledge including Microsoft Office and Internet.