What are the responsibilities and job description for the Prior Authorization Specialist- infusion therapy position at Thrive Health IV?
Prior Authorization/ Claim Follow-Up Coordinator
- Obtain new patient referral information from our referring providers or patients on a daily basis.
- Verify insurance coverage for the therapy being prescribed from primary, secondary, or tertiary payers.
- Confirm patient liability for the prescribed therapy.
- Gather and exchange information to gain authorization for therapy requested and re-authorization as necessary, which may include gathering patient-specific clinical data from referral sources
- Enter patient demographic information into the clinical or billing systems and ensure that the patient database is complete
- Communicate with other departments regarding the status of referrals and documentation requests.
- Notify patients or referral sources regarding prior authorization status as necessary.
- Enroll commercial patients in copay assistance, track and monitor for re-enrollment
- Review benefits for all patients on the schedule in Athena a minimum of 2 days before their appointment date, and attempt to collect from the patient
- Assist with out-of-network claims negotiation requests for the following procedures billed to insurance
- Assist with aging and claim follow up for all claims as directed by the administrative staff
Qualifications:
· Prior experience in a similar role for biologics and infused medicines
· Demonstrated customer-service skills.
· Be a person of integrity and character, willing to embrace change and make a positive impact in the lives of patients and co-workers.
· Ability to work with staff members at all levels of the organization in a cooperative, team-oriented manner.
· Minimum education requirement is a high school diploma or GED.
· Five years’ experience in a healthcare environment, preferably in an infusion center.
· Proficient in PC windows environment.
· Proficient in use of English language both in written and verbal communication.
· Must be able to communicate with individuals of varying socioeconomic backgrounds.
· Ability to work in various positions (standing, sitting, bending, walking) for extended periods of time during an 8-hour workday.
· Ability to remain calm and professional regardless of workload or time constraints.
Job Types: Full-time, Part-time
Salary: $25.00 - $35.00 per hour
Benefits:
- Health insurance
Schedule:
- Monday to Friday
Experience:
- ICD-10: 1 year (Preferred)
Work Location: One location
Job Types: Full-time, Part-time
Pay: $25.00 - $35.00 per hour
Benefits:
- Health insurance
Experience:
- ICD-10: 1 year (Preferred)
Work Location: In person
Salary : $25 - $35