Prior Authorization Coordinator I
IVX Health - Brentwood, Tennessee, United States, 37027Work at IVX Health
Overview
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Overview
LevelEntry
Job LocationCorporate IVX Health - Brentwood, TN
Remote TypeFully Remote
Position TypeFull Time
Education LevelHigh School Diploma / GED
Travel PercentageNo Travel Required
Job ShiftMonday - Friday, regular business hours
Job CategoryRevenue Cycle
Description
Join us at IVX Health and help make an impact our patients lives from the start of their patient journey! We are seeking a
Prior Authorization Coordinator
to support our continued growth! Our HQ is based right outside of Nashville in Brentwood, TN. We are seeking candidates nationwide with the option to work in-office, hybrid, or fully-remote!
ABOUT USIVX Health is a national provider of infusion and injection therapy for those with Rheumatoid Arthritis, Crohn's Disease, Multiple Sclerosis and other complex chronic conditions. IVX offers a different, better approach to caring for our patients and believes it is vital to take the same approach with our employees. We strive to empower our team to succeed while embodying our core values:
Be Kind ,
Do What's Right ,
Never Settle ,
Make It Happen , and
Enjoy the Ride .
ABOUT THE ROLEOur Prior Authorization Coordinators form the core of our Revenue Cycle team. Reporting to the Manager of Prior Authorization, the Prior Authorization (PA) Coordinator I works collaboratively and interfaces directly with IVX Health clinical staff, payer representatives, and patients daily to review scheduled services and to ensure complete and accurate information is documented. This role completes necessary clinical review for prior authorizations as required by governmental and commercial payers, satisfying maximum net revenues and minimum avoidable losses for authorizations. The ability to multi-task in multiple business office / practice management systems and offer exceptional customer service is the foundation of this role.
RESPONSIBILITIESReview and process all assigned Prior Authorization orders to completionObtain clinical information (including but not limited to medical history, diagnosis, and any relevant lab reports) necessary to complete the Prior AuthorizationDiligently reviews the clinical information for completeness for insurance requirements and follows up with any questionsFollow the Prior Authorization Criteria for medications and submits requestsCommunicate with insurance companies to pre-certify/authorize medicationsInvestigate outstanding medical documentation to ensure a patients account is not suspendedAssist with any denied claims to resolve potential mistakes by providing clinical informationAssist with medication change process by providing clinical informationClearly support patient experience through patient-centered communications demonstrating excellent customer service skillsAssist with payer directed patients from receipt through scheduling while actively communicating with all stakeholders.Perform duties and job functions in accordance with the policies and procedures established for the departmentRecommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performedActively participate in problem identification and coordinates resolution between appropriate partiesBENEFITS
Comprehensive Medical, Dental, and Vision Insurance plans. Plans include prescription drug coverage as well as telemedicine servicesAdditional options for supplemental health protection plans including Accident, Critical Illness, and Hospital Indemnity,Life and AD&D InsuranceDependent Care Flexible Spending AccountVoluntary Short-Term and Long-Term Disability CoverageFertility Healthcare and Family Building Benefits through CarrotFree counseling services and resources for emotional, physical and financial wellbeing401(k) Plan with company-matchEducation assistance (Tuition reimbursement, Certification support)Charitable Giving Match and Volunteer PTO ProgramFlexible work schedule that promotes a positive work-life balanceEmployee Referral Bonus ProgramQualifications
ESSENTIAL SKILLS AND COMPETENCIES
Knowledge of current authorization regulatory guidelines and requirementsExcellent organizational, consultative, analytical and problem-solving skillsAbility to work independently under general supervision and effectively prioritize workloadAbility to multitask and adapt to fast-paced work environmentStrong interpersonal skillsAbility to collaborate and communicate at all levels of an organizationKnowledge of basic medical terminologyProficiency with standard office software applications (Microsoft Office, Outlook, Teams, etc.)REQUIRED EDUCATION & EXPERIENCE
High School Diploma or GED required2 Year / Associates Degree in Medical Office Managing, Medical Insurance, or Medical Coding strongly preferredThree years experience working in hospital or clinical service access, physician office scheduling, or similar roleCertified Medical Assistant is a plus!
WAGE RANGEPay is based on a number of factors including market location, job-related knowledge, skills, and experience and is benchmarked against similar organizations to our size and industry. For our Prior Authorization Coordinator role, we generally pay new hires between 20.00 and 24.00 per hour. It is not typical for an individual to be hired at or near the top of the range for roles and compensation decisions are dependent on the facts and circumstances of each situation. In addition to cash pay, full-time regular positions are eligible for 401(k), health benefits, and other company benefits; some of these benefits may also be available for part-time positions.
EEO STATEMENTIVX Health is proud to be an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. IVX Health wants to have the best available people in every job, and we make employment decisions on the basis of business needs, job requirements, individual qualifications, and merit. Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, military and veteran status, age, physical or mental disability, genetic characteristic, reproductive health decisions, family or parental status, or any other legally protected category in accordance with applicable federal, state, or local laws. IVX Health prohibits discrimination, harassment, or retaliation of any kind based on any of these characteristics. Equal employment opportunity will be extended to all persons in all aspects of the employer-employee relationship and all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation benefits, and separation of employment.