Prior Authorization Coordinator
New
I
IVX HealthHealthcare
NationwideFull-TimeMiddle
Salary22 - 24 USD per hour
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Job Details
- Experience
- Minimum of three (3) years of experience
- Required Skills
- Microsoft Office Suite
Requirements
- Minimum of three (3) years of experience in hospital or clinical service access, physician office scheduling, or a similar role.
- Hands-on experience with prior authorizations for biologics, oncology, or specialty therapies.
- Strong understanding of payer guidelines.
- Proficiency in Electronic Health Records (EHR) systems and payer portals.
- Proficiency in Microsoft Office Suite.
- High school diploma or GED required.
- Excellent communication skills for interaction with clinical teams, insurance companies, and patients.
- Strong initiative, accountability, and ability to perform in independent work environments.
- Associate's degree in Medical Office Management, Medical Insurance, or Medical Coding (preferred).
- Certified Medical Assistant (CMA) certification (preferred).
Responsibilities
- Review Prior Authorization orders thoroughly to ensure timely and accurate completion.
- Obtain and assess clinical documentation such as medical history, diagnosis, and lab reports.
- Submit and track authorization requests according to medication approval criteria.
- Investigate and resolve denied claims and documentation concerns.
- Communicate effectively with patients, clinical staff, and insurance representatives.
- Maintain up-to-date knowledge of evolving payer policies to enhance workflow efficiency.
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