Family Allergy & Asthma
Prior Authorization Coordinator - Hybrid
Family Allergy & Asthma, Louisville, Kentucky, us, 40201
Prior Authorization Coordinator - Hybrid
Title:
Prior Authorization Coordinator - Hybrid
Schedule:
Full Time – Monday to Friday 8:30am-5:00pm
Hybrid:
Will train in office. After training will be full time remote.
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 makes 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.
Collects 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.
Maintains and follows 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.
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.
Regularly required to use hands to handle, or feel objects, tools, or controls; reach with hands and arms; and talk or hear.
Frequently required to stand, walk, stoop, kneel, crouch, reach, push, pull, bend and sit. On average, the employee may be standing or walking 80% of their shift.
Occasionally lift and/or move up to 30 pounds.
Specific vision abilities required: close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus.
Specific communication abilities required: the ability to talk and hear to converse with others, discern, convey, express oneself, and exchange information.
Work Environment This role operates primarily in an office environment but may require occasional travel for conferences, meetings, or client interactions. Remote employees are not applicable to this environment. The noise level 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.
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, 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.
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Title:
Prior Authorization Coordinator - Hybrid
Schedule:
Full Time – Monday to Friday 8:30am-5:00pm
Hybrid:
Will train in office. After training will be full time remote.
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 makes 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.
Collects 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.
Maintains and follows 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.
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.
Regularly required to use hands to handle, or feel objects, tools, or controls; reach with hands and arms; and talk or hear.
Frequently required to stand, walk, stoop, kneel, crouch, reach, push, pull, bend and sit. On average, the employee may be standing or walking 80% of their shift.
Occasionally lift and/or move up to 30 pounds.
Specific vision abilities required: close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus.
Specific communication abilities required: the ability to talk and hear to converse with others, discern, convey, express oneself, and exchange information.
Work Environment This role operates primarily in an office environment but may require occasional travel for conferences, meetings, or client interactions. Remote employees are not applicable to this environment. The noise level 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.
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, 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.
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