San Antonio, TX
Responsible for the coordination and process of prior approval/medically necessary contact lens requests which includes, but is not limited to, logging, faxing, copying, and filing etc.
Receive, review and process prior approval requests in accordance to company and regulatory agency standards.
Duties: Prepare requests for medically necessary contact lenses with supporting documentation for review by professional peer reviewer(s) within company, client and regulatory agency time frames.
Respond quickly and professionally to requests for prior approval and/or medically necessary contact lens while maintaining required client performance standards
Notify members, providers and clients as required using approved documents and or via telephone
Provide timely and accurate followup to associate, client and/or health care professionals as needed.
Responsible for coordinating the prior approval/medically necessary processes to meet all client performance guarantees
Responsible to ensure that files are documented with appropriate information (i.e. date stamped, signed, etc.)
Qualifications: RN Required Associates Degree