Prior Authorization Coordinator

🕒 Julho 29

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IVX Health

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

Fundada em 2013

🏥 Saúde

💊 Farmacêutico

👥 B2C

Healthcare • Pharmaceuticals • B2C

A IVX Health é uma rede nacional de centros de infusão ambulatorial que oferece terapias de infusão e injeção biológica para pacientes com condições crônicas complexas, como doença de Crohn, esclerose múltipla, artrite reumatóide, psoríase, lúpus e asma grave. A empresa enfatiza o conforto e a conveniência dos pacientes com suítes privativas, agendamento flexível, incluindo noites e fins de semana, opções de seguro dentro da rede e atendimento de alta qualidade prestado por ARNPs, RNs e diretores médicos em várias localizações nos EUA.

Descrição

• 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.

🎯 Requisitos

• Prior Authorization Expertise is Essential – You must have hands-on experience with prior authorizations for biologics, oncology, or specialty therapies, along with a strong understanding of payer guidelines. • Exceptional Communication Skills – This role involves frequent interaction with clinical teams, insurance companies, and patients. You must be able to communicate clearly, professionally, and persistently follow up when needed. • Self-Motivated and Accountable – If you work remotely, you are 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.

🏖️ Benefícios

• 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.