Authorization Coordinator I

Nufactor•Temecula, CA

11d•Onsite

About The Position

The Authorization Coordinator is responsible for maintaining authorizations for all active patients with NuFACTOR. This role involves initiating all re-authorization requests at least 30 days in advance and ensuring all deliveries are properly verified prior to shipping. The position requires strong organizational skills, attention to detail, and effective communication abilities. The Authorization Coordinator will work closely with physicians' offices, patients, and payors to ensure seamless treatment continuation and accurate financial obligation management. Adherence to company policies, federal and state regulations, and compliance requirements is paramount. The role also emphasizes professionalism, teamwork, and a proactive approach to problem-solving.

Requirements

High School diploma or equivalent required.
Must have strong organizational skills
Must have a detail orientation and the proven ability to prioritize work
Must have effective verbal and written communication skills
Must have the ability to work with limited supervision and as part of a team
Sound decision-making abilities
Ability to use and understand Microsoft Office skills and internet technologies.

Nice To Haves

One (1) year health care related experience in a pharmacy, home healthcare, infusion related setting or hospital is preferred
Benefit verification and prior authorizations for specialty medications.
Knowledge of medical and pharmacy terminology and calculations, general pharmacy dispensing requirements, including identification of items requiring prescription and valid prescribing data.
Excellent verbal and written communication skills and the ability to interact effectively with patients, co-workers and management.
Ability to work with a high degree of accuracy in an organized, detail oriented manner with appropriate follow-up when required.
Ability to communicate effectively and at the appropriate level with healthcare professionals and peers.
Ability to prioritize work and make decisions independently and effectively, often quickly in response to dynamic patient needs, with limited supervision and direction, except where required/restricted by law.
Working knowledge of state, federal and Joint Commission guidelines/regulations/laws.
Ability to exercise discretion and maintain confidentiality to the level of required HIPAA standards.

Responsibilities

Initiates the re-authorization process by gathering relevant data from the physician’s office, and properly submitting re-authorizations to avoid delays in treatment.
Monitors re-authorizations in NuFACTOR system of record Authorization tracking and works 30 days ahead of expiration date.
Notifies proper departments of any issues or updates relating to coverage or authorization.
Annually determines patient’s financial obligation, out of pockets expense and copays.
Communicates with patients on any benefit changes or changes to their financial obligations.
Enters all communications and updates in the NuFACTOR system of record notes while working the re-authorizations for active patients.
Answers telephones utilizing appropriate etiquette and speaks to referral sources, patients, family members, clinicians and payors.
Complies with all NuFactor policies and procedures and compliance requirements when engaging in activities related to the company.
Adheres specifically to all company policies and procedures, Federal and State regulations, and laws.
Display dedication to position responsibilities and achieve assigned goals and objectives.
Always represent the Company in a professional manner and appearance.
Understand and internalize the Company’s purpose.
Display loyalty to the Company and its organizational values.
Display enthusiasm and dedication to learning how to be more effective on the job and share knowledge with others.
Work effectively with co-workers, internal and external customers and others by sharing ideas in a constructive and positive manner; listen to and objectively consider ideas and suggestions from others; keep commitments; keep others informed of work progress, timetables, and issues; address problems and issues constructively to find mutually acceptable and practical business solutions; address others by name, title, or other respectful identifier, and; respect the diversity of our work force in actions, words, and deeds.
Comply with the policies and procedures stated in the Injury and Illness Prevention Program by always working in a safe manner and immediately reporting any injury, safety hazard, or program violation.
Ensure conduct is consistent with all Compliance Program Policies and procedures when engaging in any activity on behalf of the company.
Immediately report any concerns or violations.
Other duties as assigned.