PHRN Prior-Authorization

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced PHRN to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you
Account Specific Roles and Responsibilities
Receive and review claims requiring Prior Authorization.
Access and utilize the CMM key to complete required clinical questionnaires.
Locate and extract appropriate clinical information from PCC (PointClickCare) to support PA submissions.
Accurately complete and submit Prior Authorization requests to health plans when applicable.
Maintain accurate documentation of all actions taken within required systems.
Ensure compliance with payer guidelin...