Soleo Health logo
Soleo Health

Simplifying Complex Care

Infusion Prior Authorization Coordinator

GeneralGeneralFull TimeRemoteMid LevelTeam 501-1,000Since 2013H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

1 day ago

Salary

$20 - $23 / hour

Seniority

Mid Level

High School2 yrs expEnglish

Job Description

Infusion Prior Authorization Coordinator

Soleo Health

• Ensure seamless patient care by maintaining prior authorizations, copay assistance, and verifying existing insurance coverage for ongoing services • Must have a solid working knowledge of insurance plans and benefit structures to obtain detailed benefit information and maximize plan benefits • Verify insurance benefit information monthly via multiple methods such as online tools, calling payors or processing test claims • Generates a prior authorization expiration report weekly, bi-weekly, or monthly • Review clinical documents for prior authorization/pre-determination submission purposes • Secures prior authorization, pre-determination, or medical review • Contact prescriber’s office to obtain information that is required to complete ongoing re-authorization and verification of benefits • Places outbound calls to patients or prescriber’s offices to notify of any delays due to more information needed to process or due to a prior authorization • Document insurance coverage of medications, administration supplies, and related infusion services including prior authorization requirements and coordination of benefits • Provides exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner • Ensures the appropriate notification of patients regarding their financial responsibility, benefit coverage, and payor authorization for services to be provided • Generates patient forms • Maintains up-to-date prior authorization report • Other duties as assigned

Job Requirements

  • High school diploma or equivalent required
  • At least 2 years of specialty infusion intake/admissions
  • Previous medical and pharmacy benefit experience is required
  • Initiating and securing prior authorizations, pre-determination, and appeals
  • Ability to interpret payor contract fee schedules based on NDC and HCPCS units
  • Ability to effectively handle multiple priorities within a changing environment
  • Basic level skill in Microsoft Excel and Word

Benefits

  • Competitive Wages
  • 401(k) with a Match
  • Referral Bonus
  • Paid Time Off
  • Great Company Culture
  • Annual Merit Based Increases
  • No Weekends or Holidays
  • Paid Parental Leave Options
  • Affordable Medical, Dental, & Vision Insurance Plans
  • Company Paid Disability & Basic Life Insurance
  • HSA & FSA (including dependent care) Options
  • Education Assistance Program

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