Biologics & Prior Authorization Coordinator

MIDSTATE SKIN INSTITUTE, LLC•Ocala, FL

3d•Onsite

About The Position

This is a full-time position. This position is eligible for health insurance, paid time off, 401k, etc. This position reports to the Practice Manager as their direct supervisor.

Requirements

High school diploma or equivalent
Prior experience in a medical office or other healthcare facility
Knowledge of biologics and other prescriptions
Experience and Knowledge with various health insurances, including Prior Authorizations
Knowledge of medical office systems and procedures, EMR
Excellent time management skills and ability to multi-task and prioritize work
Friendly, team player, excellent collaborator, and communicator

Nice To Haves

Knowledge of NexTech system
Knowledge of Biologics process

Responsibilities

Managing a patient’s journey from prescription to drug acquisition
Navigates the complexities of patient access on behalf of those prescribed biologics
Supports doctors, patients and Specialty Pharmacy through a variety of tasks related to patient prescriptions including status and delays
Communicates with patients, insurance providers, physicians and other staff as needed
Completes enrollment forms and submits prior authorizations for Specialty Medications
Reviews benefit verifications and expected costs with patients
Writes appeals and letters of medical necessity as needed and/or works with Specialty Pharmacy to complete
Directs patient assistance and bridge programs
Appropriately interacts with patients, providers, and other staff
Responds to patient phone calls and provider tasks in timely manner
Full documentation of all communications
Coordinates efforts of specialty pharmacies and manufacturer HUBs
Completes all other Prior Authorization regarding other medications
Organizes, processes and uploads incoming faxes that pertain to biologics and/or prior authorizations
Submits refills for biologic medications
And other duties/tasks as assigned by management