Insurance Authorization Specialist: Infusion Therapy/Biologics

About ThrIVewell Infusion:

ThrIVewell is a premier infusion and injection center that provides IV therapy services to patients across the US. We specialize in delivering high-quality care to patients with complex chronic and rare diseases, such as Rheumatoid Arthritis, Multiple Sclerosis, Crohn's, Colitis and more. Many of these treatments are referred to as Biologics and are specialized medications. Our team are experts in the "Script" to "Chair" process of helping a patient referred by their physician to receive authorization, financial assistance and procure their medications using their insurance benefits, prior to treatment.

We are dedicated to ensuring that every patient receives the personalized treatment they deserve, with a focus on compassion, care, convenience, and comfort. Thrivewell supports a culture founded on principles of family and teamwork. Our mission is to increase healthcare access to those in need and ensure all treatment is provided with sophisticated quality and a high standard of care.

Position Overview:

We are seeking a highly skilled and experienced Authorization Expert to join our team. In this role, you will be responsible for obtaining prior authorizations from insurance companies for medications used in infusion therapy of rare and chronic diseases. You will play a critical role in ensuring that patients have access to the medications they need to manage their conditions effectively while ensuring continuity across their treatment cycles.

Knowledge on specialty medication procurement vs buy and bill model is a huge plus!

Responsibilities:

• Prepare and submit prior authorization requests to insurance companies, ensuring accuracy and completeness of documentation.
• Collaborate with various departments to ensure necessary clinical information is obtained for prior authorization requests.
• Review insurance policies and guidelines to determine the requirements for obtaining prior authorizations and ensure continuity of authorizations across the treatment timeframe.
• Review medical information and identify necessary documents for approval across various insurance payers.
• Follow up on prior authorization requests, including denials and appeals, when necessary, to ensure timely approval of medications.
• Maintain accurate records of prior authorization requests and approvals in EMR and support software.
• Assist medication procurement team by receiving and logging deliveries of txs

Qualifications:

• Bachelor's degree (preferred) or
• Minimum of [3] years of experience working in healthcare, with a focus on prior authorizationsfor high-value medications for rare chronic diseases or
• Previous experience in healthcare administration, authorization coordination, or related field, required.
• Strong knowledge of insurance policies and guidelines related to prior authorizations.
• Excellent communication and interpersonal skills, with the ability to effectively advocate for patients with insurance companies.
• Proficiency in computer applications, including medical management systems and Microsoft Office suite.
• Ability to work effectively both independently and as part of a team in a fast-paced environment.
• Detail-oriented and organized, with the ability to manage multiple tasks and priorities simultaneously.
• Proficiency in using EMR systems and other relevant software applications.

Benefits:

• Competitive salary based on experience.
• Comprehensive benefits package, including healthcare coverage, retirement plans, and paid time off.
• Opportunities for professional development and advancement within the company.
• A supportive and collaborative work environment dedicated to providing exceptional patient care.

At Thrivewell Infusion, we are committed to creating an inclusive and diverse workplace. We welcome applicants from all backgrounds and identities.

Join our team and help us deliver exceptional care to our patients!

THRIVEWELL INFUSION- Saving Lives Drip by Drip!

www.Thrivewellinfusion.com

Job Type: Full-time

Pay: $45,000.00 - $60,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee discount
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Vision insurance
• Wellness program

Application Question(s):

• What information is essential to have on hand when calling to start a prior authorization for a patient?
• How do you stay organized when you have prior authorizations pending?
• What are your strengths and areas for improvement?

Experience:

• Insurance Prior Authorizations: 2 years (Required)
• Medical office: 1 year (Required)
• Infusion Authorizations: 1 year (Required)

Ability to Commute:

• New York, NY 10019 (Required)

Work Location: Hybrid remote in New York, NY 10019

Salary : $45,000 - $60,000