Insurance Authorization Specialist: Infusion Therapy/Biologics

Job Description

Job Description

Join the ThrIVewell Family!

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!

This role will be on site.

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 authorizations for 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!