Authorization Specialist

Responsible for prior authorizations and reauthorization Responsible for tracking authorization status and adding to all necessary systems Responsible for confirming medical necessity Negotiates single case agreements for out of network insurance cases Establish and execute systems for maximizing insurance coverage and reimbursement Coordinates with clinics and providers to ensure all necessary documentation is being tracked and logged to allow for reauthorization and continued care Works with outside pharmacies for Spravato authorization and coverage Collaborates and facilitates needed changes to the plan of care/ level changes Continuously checks medical policies for changes to medical criteria needed for services Assist patients in enrolling into the Spravato REMS program and Spravato Savings Program, JPAP as needed Schedule patients for their Spravato induction phase Patient communication Exhibit a high level of professionalism, empathy, and positivity #J-18808-Ljbffr Relief Mental Health