High-quality, personalized care for those receiving ongoing infusion or injection therapy.
Prior Authorization Coordinator
Location
United States
Posted
43 days ago
Salary
$22 - $24 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Prior Authorization Coordinator
IVX Health
Role Description Join IVX Health as a Prior Authorization Coordinator! Join a team that’s redefining infusion care and creating exceptional patient experiences. Are you experienced in navigating the complexities of prior authorizations for biologics or oncology therapies? IVX Health is looking for a driven and detail-oriented Prior Authorization Coordinator to support our rapidly growing team. In this role, you’ll have the opportunity to make a meaningful impact by facilitating the approval process for life-changing specialty treatments. Location and Schedule at a Glance: - Work Options: Fully Remote, Hybrid, or In-office (Brentwood, TN) - Schedule: Monday - Friday, standard business hours (no nights, weekends, or holidays) What You Will Do - Review and Process Prior Authorizations: Thoroughly review Prior Authorization orders and ensure timely and accurate completion. - Manage Clinical Documentation: Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. - Submit and Track Prior Authorizations: Follow criteria for medication approvals and accurately submit requests to insurance providers. - Resolve Authorization Issues: Investigate and resolve outstanding medical documentation concerns and assist in resolving denied claims. - Support Patients and Providers: Communicate effectively with patients, clinical staff, and insurance representatives regarding the Prior Authorization process. - Ensure Compliance and Process Improvement: Stay up to date with evolving payer policies and identify ways to enhance workflow efficiency. - Perform Additional Duties: Take on other responsibilities as assigned to support patient care and operational objectives. Qualifications - Prior Authorization Expertise is Essential: Hands-on experience with prior authorizations for biologics, oncology, or specialty therapies, along with a strong understanding of payer guidelines. - Exceptional Communication Skills: Frequent interaction with clinical teams, insurance companies, and patients; ability to communicate clearly and professionally. - Self-Motivated and Accountable: Expected to be present, engaged, and consistently perform at a high level without direct supervision. - Tech-Savvy and Detail-Oriented: Proficiency in Electronic Health Records (EHR) systems, payer portals, and Microsoft Office Suite is required. - High School Diploma or GED required. - Associate’s degree in Medical Office Management, Medical Insurance, or Medical Coding is a plus. - Minimum of three (3) years of experience in hospital or clinical service access, physician office scheduling, or a similar role. - Certified Medical Assistant (CMA) is a plus. - Experience with prior authorizations for biologics, oncology, or specialty therapies preferred. Benefits - Comprehensive Healthcare: Medical, dental, and vision coverage, including prescription drug plans and telemedicine services. - Flexible Savings Options: Choose from Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA) to manage healthcare costs. - Supplemental Protection: Accident, critical illness, and hospital indemnity plans to provide additional financial security. - Dependent Care FSA: Pre-tax savings for eligible childcare and dependent care expenses. - 401(k) Retirement Plan: Secure your future with a competitive company match. - Disability Coverage: Voluntary short-term and long-term disability plans to protect your income. - Fertility and Family Support: Resources and benefits designed to support fertility care and family planning. - Life and AD&D Insurance: Financial protection for you and your loved ones. - Counseling and Wellness Support: Free resources to support emotional, physical, and financial well-being. - Education Assistance: Tuition reimbursement and certification support to help you grow in your career. - Continuing Education: Access to a CEU library for ongoing professional development. - Charitable Giving and Volunteer Program: Matched donations and paid volunteer time off to support causes you care about. - Employee Referral Bonus: Earn rewards for helping us find top talent.
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