Prior Authorization Coordinator

IVX Health

6h•$22 - $24•Remote

About The Position

Join IVX Health as a Prior Authorization Coordinator! Join a team that’s redefining infusion care and creating exceptional patient experiences. Are you experienced in navigating the complexities of prior authorizations for biologics or oncology therapies? IVX Health is looking for a driven and detail-oriented Prior Authorization Coordinator to support our rapidly growing team. In this role, you’ll have the opportunity to make a meaningful impact by facilitating the approval process for life-changing specialty treatments. Our HQ is based just outside of Nashville in Brentwood, TN, but we are seeking candidates nationwide with the option to work fully remote, hybrid, or in-office!

Requirements

Prior Authorization Expertise is Essential – You must have hands-on experience with prior authorizations for biologics, oncology, or specialty therapies, along with a strong understanding of payer guidelines.
Exceptional Communication Skills – This role involves frequent interaction with clinical teams, insurance companies, and patients. You must be able to communicate clearly, professionally, and persistently follow up when needed.
Self-Motivated and Accountable – If you work remotely, you are expected to be present, engaged, and consistently perform at a high level without direct supervision.
Tech-Savvy and Detail-Oriented – Proficiency in Electronic Health Records (EHR) systems, payer portals, and Microsoft Office Suite is required.
High School Diploma or GED required.
Minimum of three (3) years of experience in hospital or clinical service access, physician office scheduling, or a similar role.

Nice To Haves

Associate’s degree in Medical Office Management, Medical Insurance, or Medical Coding is a plus.
Certified Medical Assistant (CMA) is a plus.
Experience with prior authorizations for biologics, oncology, or specialty therapies preferred.

Responsibilities

Review and Process Prior Authorizations – Thoroughly review Prior Authorization orders and ensure timely and accurate completion.
Manage Clinical Documentation – Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions.
Submit and Track Prior Authorizations – Follow criteria for medication approvals and accurately submit requests to insurance providers.
Resolve Authorization Issues – Investigate and resolve outstanding medical documentation concerns and assist in resolving denied claims.
Support Patients and Providers – Communicate effectively with patients, clinical staff, and insurance representatives regarding the Prior Authorization process.
Ensure Compliance and Process Improvement – Stay up to date with evolving payer policies and identify ways to enhance workflow efficiency.
Perform Additional Duties – Take on other responsibilities as assigned to support patient care and operational objectives.

Benefits

Comprehensive Healthcare – Medical, dental, and vision coverage, including prescription drug plans and telemedicine services.
Flexible Savings Options – Choose from Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA) to manage healthcare costs.
Supplemental Protection – Accident, critical illness, and hospital indemnity plans to provide additional financial security.
Dependent Care FSA – Pre-tax savings for eligible childcare and dependent care expenses.
401(k) Retirement Plan – Secure your future with a competitive company match.
Disability Coverage – Voluntary short-term and long-term disability plans to protect your income.
Fertility and Family Support – Resources and benefits designed to support fertility care and family planning.
Life and AD&D Insurance – Financial protection for you and your loved ones.
Counseling and Wellness Support – Free resources to support emotional, physical, and financial well-being.
Education Assistance – Tuition reimbursement and certification support to help you grow in your career.
Continuing Education – Access to a CEU library for ongoing professional development.
Charitable Giving and Volunteer Program – Matched donations and paid volunteer time off to support causes you care about.
Employee Referral Bonus – Earn rewards for helping us find top talent.