About the role

Aplyr's Quick Take

This role is about managing the prior authorization process for pharmacy support, ensuring that healthcare providers have the necessary information to complete coverage requests. It's primarily an individual contributor role focused on communication and problem-solving with insurance plans and providers.

Good fit

Ideal candidates have experience in prior authorizations or medical insurance, strong communication skills, and the ability to work independently while being a team player. Adaptability to new systems is also important.

Worth noting

The company is in a growth phase, expecting to double its workforce soon, which could mean more opportunities for advancement. However, the role may involve high-pressure situations due to the nature of healthcare and insurance processes.

PHIL is looking for a full-time Prior Authorization Specialist - with a focus on pharmacy support for Monday through Friday shifts.

About the Company:

Founded in 2015, PHIL is a San Francisco-based Series D health-tech startup, pioneering the first Software Therapy Deployment Platform for Specialty Pharmaceuticals that treat complex health conditions. Our mission is to ensure consistent, reliable and affordable access to complex therapeutics for our patient community. Partnering with pharmaceutical manufacturers, PHIL offers digital patient access services to improve health outcomes for patients by delivering affordable and timely access to high-cost Specialty therapeutics. We recently completed our Series D financing led by Warburg Pincus, with $122M in capital raised to date with near-term line of sight to profitability. Headquartered in Scottsdale with operational hubs in Scottsdale AZ and Columbus, OH, the company currently employs over 120 individuals and expects to double its employee base in the coming year. For more information on PHIL, visit https://phil.us/

Position Overview

The most important goal here at PHIL is to improve patients' medication adherence by offering a quick and effortless way for patients to get their medications on time. Prior Authorization Specialists ensure that prescribing offices have all of the information that they need in order to efficiently complete electronic coverage requests in addition to providing phone and email support.

Job Duties:

Verifies patient insurance coverage utilizing phone or online resources
Submit prior authorizations to insurance plans in a timely manner via electronic portal
Troubleshoots prior authorization submissions and prescription processing with health care providers utilizing phone or online resources
Verbally assist providers in navigating appeals processing
Ensures all pertinent medical documentation is accurate and present prior to authorization submission
Compiles trends in authorization determinations for client and prescriber education
Document activities appropriately in process notes using our operating system
Work closely with our Customer Support team to ensure the success of patients that are recommended to us by their physician's office

Requirements

Proven team player, but can solve problems independently as well
Exceptional written and verbal communication skills
Easily adapt to new system and workflow changes
Demonstrate experience working in prior authorizations, medical insurance billing, and/or health insurance (required)
Working knowledge of ICD-10 codes and prescription drug names (preferred, but not required)
Ability to successfully navigate between multiple systems throughout the course of the workday, this includes but is not limited to operational software and vendor portals
Demonstrate flexibility to perform duties wherever volume deems it necessary
Customer service experience (preferred)
Access to reliable, high-speed internet to meet the needs of remote processing (required)
Reliable transportation and ability to work in office as required

Benefits

Ground floor opportunity with one of the fastest-growing startups in health-tech
Fully remote working environment available in the following states: AZ, CA, CO, FL, GA, IA, ID, IL, IN, MA, MI, MO, NC, NH, NJ, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV
Solve a problem that matters: be part of a company that uniquely leverages technology to bring wellness to all of its stakeholders

Skills & Tags

go ai

Aplyr's read

Phil is a healthcare technology company revolutionizing medication access with a team dedicated to optimizing client operations and patient support.
Synthesized from recent postings & public sources

What's promising

•Phil's technology significantly improves patient access to medications, addressing a critical healthcare need.
•The company offers diverse roles, from pharmacy management to client success, indicating growth and varied career paths.
•Phil's focus on client optimization suggests a strong commitment to operational efficiency and customer satisfaction.

What to watch

•The healthcare technology sector is highly competitive, posing challenges for Phil's market share growth.
•Limited public information about Phil's financial stability may concern potential applicants.
•Rapid expansion can strain resources, potentially impacting employee workload and job satisfaction.

Why Phil

•Phil emphasizes a closed-door pharmacy model, which is less common and may appeal to professionals seeking a unique work environment.
•The company's integration of technology in pharmacy operations sets it apart from traditional healthcare providers.
•Phil's roles in client optimization highlight a specialized focus on enhancing client relationships and service delivery.

Aplyr’s read is generated by AI from public sources. Was it useful?