Prior Authorization Coordinator

🕒 5 days ago

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IVX Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

🏥 Healthcare

💊 Pharmaceuticals

👥 B2C

Healthcare • Pharmaceuticals • B2C

IVX Health is a national network of outpatient infusion centers that provides biologic infusion and injection therapies for patients with complex chronic conditions such as Crohn’s disease, multiple sclerosis, rheumatoid arthritis, psoriasis, lupus, and severe asthma. The company emphasizes patient comfort and convenience with private suites, flexible scheduling including evenings and weekends, in-network insurance options, and high-quality care delivered by ARNPs, RNs, and medical directors across multiple U. S. locations.

📋 Description

• 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.

🎯 Requirements

• 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.

🏖️ 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.