PHRN Prior-Authorization | WFH

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 re...