Prior Authorization Specialist
About The Position
Infusion For Health is a referral-based infusion center serving providers across California, Arizona, Nevada, Washington, Colorado, and Missouri. The company provides infusion therapy in comfortable private rooms and focuses on exceptional service and patient-focused clinical care. The Prior Authorization Specialist supports the patient care operations department by managing authorizations and related follow-up. This is a full-time, onsite position at the company’s Brea headquarters, Monday through Friday, 40 hours per week. Compensation is $23–$27 per hour, depending on experience, plus benefits.
Requirements
- At least 2 years of experience in infusion or pharmacy prior authorization.
- At least 2 years of experience applying knowledge of Medicare, Medicaid, and managed care reimbursement guidelines.
- Ability to manage multiple priorities in a changing environment, with an emphasis on paperless workflow.
- Experience diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to address problems.
- Intermediate-level Microsoft Excel and Word skills.
Responsibilities
- Ensure timely and accurate submission, follow-up, and approval of authorizations, communicating with patients, insurers, and other stakeholders as needed.
- Review requested information for accuracy and completeness and confirm all supporting documents are present.
- Assist with medical necessity documentation to expedite approvals and ensure appropriate follow-up.
- Collaborate with other departments to obtain prior authorizations and appeals.
- Document interactions with insurance companies and other stakeholders in the company system.
- Record prior authorization details in patient profiles, including approval dates, billing units, procedure codes, and authorization numbers.
- Proactively work on prior authorizations approaching expiration.
- Perform job duties in accordance with the Company’s Code of Business Conduct and Ethics, policies and procedures, Corporate Compliance Agreement, applicable laws, and professional standards.
- Complete assigned duties, projects, and reports on schedule as directed by leadership.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
