Prior Authorization Coordinator
Soleo Health•Frisco, TX
•Remote
About The Position
Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care! Specialty infusion prior authorization experience required. Hours are Monday-Friday 930a-6p Central Time.
Requirements
- High school diploma or equivalent required
- At least 2 years of specialty infusion intake/admissions
- Previous medical and pharmacy benefit experience is required
- Initiating and securing prior authorizations, pre-determination, and appeals
- Ability to interpret payor contract fee schedules based on NDC and HCPCS units
- Ability to effectively handle multiple priorities within a changing environment
- Basic level skill in Microsoft Excel and Word
Nice To Haves
- Specialty infusion prior authorization experience
Responsibilities
- Must have a solid working knowledge of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits
- Verify insurance benefit information monthly via multiple methods such as online tools, calling payors or processing test claims
- Generates a prior authorization expiration report weekly, bi-weekly, or monthly
- Review clinical documents for prior authorization/pre-determination submission purposes
- Secures prior authorization, pre-determination, or medical review
- Contact prescriber’s office to obtain information that is required to complete ongoing re-authorization and verification of benefits
- Document insurance coverage of medications, administration supplies, and related infusion services including prior authorization requirements and coordination of benefits
- Provides exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner
- Ensures the appropriate notification of patients in regards to their financial responsibility, benefit coverage, and payor authorization for services to be provided
- Generates patient forms
- Maintains up to date prior authorization report
- Other duties as assigned
Benefits
- Competitive Wages
- 401(k) with a Match
- Referral Bonus
- Paid Time Off
- Great Company Culture
- Annual Merit Based Increases
- Paid Parental Leave Options
- Affordable Medical, Dental, & Vision Insurance Plans
- Company Paid Disability & Basic Life Insurance
- HSA & FSA (including dependent care) Options
- Education Assistance Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
