Simplifying Complex Care
Infusion Prior Authorization Coordinator
Location
United States
Posted
1 day ago
Salary
$20 - $23 / hour
Seniority
Mid Level
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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