Claims Support Coordinator (Prior Authorization)

Claims Support Coordinator (Prior Authorization)

The Claims Support Coordinator (Prior Authorization) is responsible for ensuring that specific workers compensation claim prescriptions are processed accurately and in a timely manner in order to increase cash flow and meet or exceed production goals. This position demands strong communication skills, quality customer service, heavy telephone interaction, problem solving skills and strong attention to detail while working in a fast-paced team environment.

What You'll Do

• Documents all communication with insurance carriers, physicians, law firms, account managers and patients in the approved format
• Follow all department policies and procedures to obtain authorization and pertinent information
• Review all letters and medical documents in regard to prior authorization
• Serves as a liaison between departments and outside parties to ensure that customers receive their medication in a timely manner
• Obtaining prior authorization for pending medications in states which this is required
• Faxing documents to insurance carriers, physicians, law firms, account managers and other parties when requested
• Consistent awareness and comprehension of pre-adjudication and formulary prior authorization processes including staying up to date on all policy/procedure changes
• General understanding of prior authorizations rules and regulations in all states in which prior authorization is required
• Communicates effectively and articulates ideas verbally and in writing
• Accountable for actions and decisions demonstrated in daily tasks
• Maintains or exceeds the expected productivity and quality
• Notifies Supervisor of trends
• Perform other duties as assigned

What You'll Need to Succeed

• 1-2 years of experience of Prior Authorization, Healthcare or Pharmacy billing
• Basic knowledge of medical terminology (preferred)
• Basic knowledge of workers compensation (preferred)
• Pharmacy Technician License (preferred)
• Excellent customer service skills
• Independent problem solver
• Detail oriented
• Microsoft Office Suite Knowledge (required)
• This position is fully onsite during the training period. Hybrid work eligibility may be considered after approximately six months, based on successful completion of training and demonstrated proficiency in the role.
• Must be available to work one extended evening per week, preferably on Thursdays.
• Ability to work a full-time schedule:
  • Monday, Tuesday, Wednesday and Friday 9:30am - 6:30pm
  • Thursday: 9:30am to 7:00pm

Why You'll Love Working at IWP

Our culture is built on our ICARE values: Ingenuity, Collaboration, Advocacy, Respect, and Empowerment. These values guide how we support our patients and how we support each other.

We offer:

• Monthly engagement events and larger annual celebrations (tent party, summer BBQ, Family Fun Day)
• Tuition reimbursement and an internal-first job posting philosophy to support career growth
• Onsite fitness center, free parking, and a competitive benefits package
• A positive, inclusive environment where employees feel valued, supported, and empowered

Make a Difference with IWP

Injured Workers Pharmacy (IWP) is proud to be THE Patient Advocate Pharmacy, helping injured workers around the country access their prescription medications with ease. As a specialized workers' compensation home delivery pharmacy, we collaborate with the legal, medical, and insurance communities to help injured workers return to a productive life. At IWP we believe in our service, but it's the people who make it a great place to work. We value our employees and strive for a culture of teambuilding, open mindedness, and fun. If that sounds like something you'd like to be part of, we'd love to hear from you! Your compensation will include a competitive salary, generous benefits, and opportunities for growth and development.

We are dedicated to attracting and retaining top talent with competitive and fair compensation. The salary range for this role is $22 - $24/hr.

IWP is an Equal Opportunity Employer. IWP does not discriminate on the basis of race, creed, color, religion, national origin, sex, sexual orientation, gender identity, age, physical or mental disability, or any other basis covered by appropriate law. All employment decisions are made on the basis of qualifications, merit, and business need. IWP is committed to providing reasonable accommodations for qualified individuals with physical and mental disabilities in our job application procedures. If you need assistance or an accommodation due to a disability, you may contact us at View email address on click.appcast.io We will make a determination on your request for reasonable accommodation on a case-by-case basis.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.