Specialty Pharmacy Prior Authorization Coordinator Template

IVX Health

10d•$24 - $25•Hybrid

About The Position

Are you detail-oriented, passionate about helping others, and looking for a role that truly makes an impact? At IVX Health, we’re redefining patient care by providing exceptional infusion and injection therapy for individuals with chronic conditions. We’re on the hunt for a proactive, problem-solving Specialty Pharmacy Prior Authorization Coordinator to join our Revenue Cycle team. This hybrid/remote role is perfect for someone who thrives in a fast-paced environment, loves collaboration, and values flexibility. As a Specialty Pharmacy Prior Authorization Coordinator, you’ll be the go-to expert ensuring timely approvals for medical services. Your work directly supports patients and clinical teams, helping to make care happen when it’s needed most. Here’s how you’ll contribute: Streamline the process: Review and submit Prior Authorization (PA) requests with precision and speed, adhering to insurance guidelines. Solve problems: Investigate denied requests, manage appeals, and find solutions to remove barriers to patient care. Collaborate for impact: Partner with clinical staff, payer representatives, and patients to facilitate approvals and keep communication clear and patient-focused. Drive efficiency: Analyze documentation, identify gaps, and ensure everything is accurate and ready to go for insurance submission. Make it personal: Provide exceptional patient-centered communication to keep everyone informed and confident in the process. Why IVX Health? Flexibility: Choose hybrid or fully remote work options to fit your lifestyle. Purpose: Play a direct role in improving patients’ lives through timely, compassionate care. Growth: Develop your skills and grow your career in a collaborative, innovative environment with exposure to leadership and decision-makers. Supportive culture: Be part of a team that values excellence, collaboration, and having each other’s backs.

Requirements

Proficient in understanding and navigating the complexities of Prior Authorization (PA) processes for both commercial and Part D payors.
Demonstrates strong analytical thinking to review and interpret clinical information accurately for PA submissions.
Exceptional verbal and written communication skills to interact professionally with IVX Health clinical teams, insurance companies, and patients.
Ability to thrive in a fast-paced environment, managing multiple PA requests simultaneously while maintaining attention to detail and meeting deadlines.
Self-starter with the ability to manage multiple tasks effectively while committing to quality and accuracy
Knowledgeable about current healthcare regulations, particularly HIPAA guidelines, ensuring confidentiality and integrity in handling patient information during PA activities.
Competent in using various office software applications such as Microsoft Office Suite (Word, Excel, Outlook), electronic health record (EHR) systems, and practice management software.
High School Diploma or GED required
Minimum three (3) years of experience working in hospital or clinical service access, physician office scheduling, or similar role required.

Nice To Haves

2 Year / Associate's degree in Medical Office Management, Medical Insurance, or Medical Coding strongly preferred.
Registered Pharmacy Technician preferred
Previous experience in a pharmacy setting is strongly preferred

Responsibilities

Review and submit Prior Authorization (PA) requests with precision and speed, adhering to insurance guidelines.
Investigate denied requests, manage appeals, and find solutions to remove barriers to patient care.
Partner with clinical staff, payer representatives, and patients to facilitate approvals and keep communication clear and patient-focused.
Analyze documentation, identify gaps, and ensure everything is accurate and ready to go for insurance submission.
Provide exceptional patient-centered communication to keep everyone informed and confident in the process.

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.