Authorization Coordinator

Druid City Vital Care•North Augusta, SC

About The Position

The Authorizations Coordinator is responsible for overseeing and managing the authorization process for home infusion services. This role ensures that all required authorizations are obtained promptly and accurately, supporting seamless patient care and compliance with insurance guidelines. The coordinator serves as a key liaison among healthcare providers, insurance companies, sales teams, and patients to facilitate timely and efficient authorization workflows.

Requirements

High school diploma or equivalent.
Prior experience in healthcare administration, patient intake, or a related field, preferably within a home infusion or pharmacy setting.
Strong communication and interpersonal skills to effectively interact with patients, providers, and team members.
Excellent organizational skills and attention to detail.
Ability to work independently and collaboratively in a fast-paced environment.
Proficiency in using computer systems and software, including electronic health records (EHR) and pharmacy management platforms.
Familiarity with maintaining medical documentation in HIPAA-compliant systems
Must be legally authorized to work in the United States without requiring employer sponsorship, now or in the future.
Provide proof of identity and employment eligibility to complete the I-9 verification process.
For multi-state operations, eligibility for licensure reciprocity or transfer of pharmacist licensure may be necessary (if applicable).

Nice To Haves

Associate or bachelor’s degree in healthcare administration, business administration, or a related field.

Responsibilities

Secure prior authorizations for home infusion services and medications from insurance providers.
Verify patient insurance coverage and benefits specific to home infusion care.
Ensure all required documentation is accurately submitted to insurance companies to support authorization requests.
Serve as a liaison between healthcare providers, patients, insurance companies, and the sales team to resolve authorization-related issues.
Communicate authorization status and potential out-of-pocket costs to patients in a timely and clear manner.
Collaborate with the pharmacy team to ensure accurate and prompt processing of medication orders.
Maintain comprehensive records of authorization requests, approvals, denials, and related communications within the electronic medical record system.
Update patient files with current authorization details and ensure compliance with regulatory and organizational standards.
Generate and submit reports on authorization activities and outcomes to management as needed.
Ensure adherence to all applicable laws, regulations, and internal policies related to home infusion services and insurance authorizations.
Participate in quality assurance initiatives to enhance the efficiency and accuracy of the authorization process.
Stay current on changes in insurance policies, procedures, and regulations that may impact authorization workflows.
Provide exceptional service to patients, healthcare providers, and insurance representatives throughout the authorization process.
Address and resolve concerns related to insurance coverage and authorization status.
Educate patients and providers on the authorization process, requirements, and timelines.