Prior Authorization Coordinator-Hybrid at Family Allergy & Asthma

Louisville, Kentucky, United States -

Full Time

Start Date

Immediate

Expiry Date

14 Jun, 26

Salary

0.0

Posted On

16 Mar, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Prior Authorization, Biologics, Specialty Medications, HIPAA Compliance, Medical Terminology, Word Processing, Spreadsheets, Charting, Flowcharting, EMR Experience, Attention To Detail, Communication Skills, Independent Work, Appeals Submission, Scheduling Peer To Peers

Industry

Medical Practices

Description

Description Title: Prior Authorization Coordinator - Hybrid Schedule: Full Time/ Monday - Friday 8:30am-5:00pm Hybrid: Will train in office. After training will be full time remote The Prior Authorization Coordinator is responsible for demonstrating knowledge and application of job duties within scope of practice and functions under the direction of the manager(s) and/or Director(s); respectfully interacts with all levels of staff; provides assistance, as needed, during assigned duty hours; participates in department activities; promotes independence; adherence to the attendance policy; encourages socialization; advocates for the quality of life of our patients while maintaining compliance with all applicable laws, regulatory and organizational standards; supports the company’s core values. Summary of Duties and Responsibilities: • Works closely with the biologic/specialty medication specialist nurse to help streamline the process’. • Communicates with providers, nurses, managers, and patients to track specialty medications and biologics given or received. • Communicates on the telephone professionally and pleasantly. Efficiently screens and directs calls and make appointments as necessary for the biologics and specialty medication process, if required • Runs reports to track appointments/biologics inventory and maintains integrity of patient charts. • Collecting all necessary documentation to complete timely and accurate submission of prior authorizations, appeals and scheduling physician peer to peers for biologics and specialty medications, as necessary. • Interacts with clients, insurance companies, sales representatives, providers, and patients, as necessary. • Maintain and follow HIPAA policies and procedures. • Monitors workflow and databases for outstanding authorization or re-authorizations to ensure timely processing of patients for services, care and billing. • Other relevant duties as assigned by manager Education, Prior Work Experience, Special Skill and Knowledge Requirements: • High school diploma/ GED • Previous experience with Biologics/Prior Authorizations preferred • Previous medical office experience preferred • Knowledge of medical terminology • Ability to work independently • Proficient and accurate with word processing (Word), spreadsheets (Excel), charting, flowcharting, and computers in general • EMR experience preferred • Attention to detail is essential • Ability to perform multiple tasks simultaneously with accuracy and efficiency while maintaining composure. • Strong written and verbal communication skills. • Must be at least 18 years of age • Experience obtaining prior authorization Physical Demands and Work Environment The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the physical demands. • While performing the duties of this job, the employee is regularly required to use hands to handle, or feel objects, tools, or controls; reach with hands and arms; and talk or hear. • The employee frequently is required to stand, walk, stoop, kneel, crouch, reach, push, pull, bend and sit. On average, injection room or clinic staff may be standing or walking 80% of their shift. • The employee must occasionally lift and/or move up to 30 pounds. • Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus. • Specific communication abilities required by this job include the ability to talk and hear in order to converse with others, discern, convey, express oneself, and exchange information. Work Environment The work environment characteristics described here represent those an employee may encounter while performing the essential functions of this job. Remote employees are not applicable to this environment. The noise level in the work environment is usually moderate; lighting is in the standard range. The employee is subject to infectious waste, potential exposure to allergens in concentrated forms, diseases, and conditions. This role operates primarily in an office environment but may require occasional travel for conferences, meetings, or client interactions. EEO Compliance: Family Allergy & Asthma provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, Prior Authorization Coordinator Created 9/2023 religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Responsibilities

The Coordinator works closely with the specialty medication nurse to streamline processes, communicating with providers, nurses, and patients to track specialty medications and biologics. Key duties include collecting documentation for timely prior authorization submissions, appeals, and scheduling peer-to-peer reviews.