Specialist Prior Authorization

Benefits

Additional Information

Our vision for the future is based on the idea that transforming financial lives starts by giving our people the freedom to transform their own. We have a flexible work environment, and fluid career paths. We not only encourage but celebrate internal mobility. We also recognize the importance of purpose, well-being, and work-life balance. Within Empower and our communities, we work hard to create a welcoming and inclusive environment, and our associates dedicate thousands of hours to volunteering for causes that matter most to them. Chart your own path and grow your career while helping more customers achieve financial freedom. Empower Yourself. Great West Global is growing their global presence and support. Our innovative and growing company is looking to fill the role of Specialist Prior Authorization . Successful candidates will learn more about the specific opportunity during the interview process. About Candalife: We Canada Life is an insurance and financial services company with its headquarters in Winnipeg, Manitoba. We provide a wide range of insurance and wealth management products for individuals, families, and business owners from coast to coast. Canada Life is focused on improving the financial, physical and mental well-being of Canadians and believes in good corporate governance & we do offer health and dental insurance, benefit and savings plans, charitable giving, and workplace mental health resources. Please log on to our website to know more about us. We offer competitive salary and bonus program that rewards your performance in achieving individual and team objectives. As well, an employee recognition program rewards exceptional performance. In addition to salary, annual bonus, and employee recognition programs, you are entitled to a comprehensive benefit package, with options to personalize the benefits package to meet the needs of you and your family. This position is suited to an individual who works well both independently and as part of a team, in an environment that is constantly changing. The Prior Authorization Coordinator, Drug Services is responsible for assessing coverage of drugs that require prior authorization before allowing coverage under a group drug plan. The incumbent reviews medical information based on guidelines in place, and in consultation with the Medical Board must determine if coverage can be approved or declined. Once the decision is made, they must communicate the results in writing to the plan member. Essential Functions: Review medical information submitted by the patient's physician to determine if all the necessary information has been received in order to complete the assessment. If not, must correspond with either the plan member or the physician to obtain missing information. Determine, based on the group plan parameters, if coverage is eligible under the group plan. Review the medical information and determine if further investigation with the Medical Board is required or if the assessment can be made based on the information available to you. Correspond in writing with plan members to communicate the decision made. Provide support to the Benefit Payment Offices, and Group Customer Contact Services regarding prior authorizations. Education & Qualifications: 1-3 years experience. Living our values of Customer View; Integrity; Partnership; and Communities. Ability to deliver high quality results with speed and accuracy in a fast paced challenging and ever-changing work environment. Strong organizational, quality and time management skills. Excellent analytical, investigative, and problem-solving skills. Strong customer service skills. Excellent verbal and written communication skills. Experience working in Excel, Word, and Outlook. Excellent keyboarding skills of 40wpm. At ease navigating through multiple computer programs simultaneously. Knowledge of the insurance industry and exposure to drug plans will be considered an asset. Knowledge of BEN, and TOCs will be considered an asset. This job description is not intended to be an exhaustive list of all duties, responsibilities and qualifications of the job. The employer has the right to revise this job description at any time. You will be evaluated in part based on your performance of the responsibilities and/or tasks listed in this job description. You may be required perform other duties that are not included on this job description. The job description is not a contract for employment, and either you or the employer may terminate employment at any time, for any reason. We are an equal opportunity employer with a commitment to diversity. All individuals, regardless of personal characteristics, are encouraged to apply. All qualified applicants will receive consideration for employment without regard to age, race, color, national origin, ancestry, sex, sexual orientation, gender, gender identity, gender expression, marital status, pregnancy, religion, physical or mental disability, mil