Prior Authorization Specialist

Prior Authorization SpecialistInfusion for Health is a referral-based infusion center that services all providers in multiple locations in California, Arizona, Nevada, Washington, Colorado, and Missouri. Our center is unique and offers individual comfortable private rooms for our patients. Our mission is to provide exceptional service in the administration of infusion therapy in a comfortable, patient-focused environment by providing exemplary professional clinical care.Our company is continuing to grow and we're looking to add a Prior Authorization Specialist to support our patient care operations department.This is a full-time, 5 days a week position, onsite at our Brea HQ office.Compensation: $23-$27/hr DOE + BenefitsKey Responsibilities:Responsible for ensuring timely, accurate submission follow-up and approval of Authorizations. Work with urgency, high-quality and high communication with patients, insurance and additional stakeholders as needed.Review the accuracy and completeness of the information requested and ensure that all supporting documents are presentAssist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performedCollaborate with other departments to assist in obtaining prior authorizations/appealsDocument all interactions with insurance companies or other stakeholders within the company systemDocument all prior authorization information, including approval dates, billing units, procedure codes, and prior authorization number in the patient profileProactively work on prior authorizations that are due to be expiredConduct job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standardsCompletes all required duties, projects, and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of the leadership.Other duties as assignedEducation and/or Experience Needed:At least 2 years experience in infusion or pharmacy prior authorization is requiredAt least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelinesAbility to effectively handle multiple priorities within a changing environment, emphasizing paperless workflowExperience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems.Intermediate level skills in Microsoft Excel & Word