Biologics Coordinator

Biologics Coordinator AllerVie | Full-Time

The Biologics Coordinator is responsible for stewarding patients on buy and bill eligible drugs across multiple locations and practices, with the primary long-term objective of converting eligible patients to a buy and bill model as a revenue-generating service. This role serves as the strategic bridge between specialty pharmacy operations and in-office buy and bill administration, driving both patient continuity and financial growth. This position provides leadership, coordination, and strategic direction across a regional patient population. It operates in close partnership with benefits and prior authorization (PA) teams, pharmacy partners, and clinical staff. The coordinator will report to the Biologics Manager and will support one or more Biologics Coordinators or Assistants.

Buy And Bill Drug Oversight

• Oversee enrollment and active management of patients on biologics drugs to ensure continuity of therapy and identification of conversion opportunities.
• Monitor eligibility changes, formulary updates, and payer policy shifts for these drugs that may open new buy and bill conversion pathways.
• Collaborate with the clinical team on therapeutic alternatives when these drugs face barriers to coverage.

Prior Authorization & Benefits

• Manage and monitor PA renewals for these patients, whether on specialty pharmacy or buy and bill, to ensure timely authorization and minimize gaps in therapy.
• Lead benefits investigation for conversion candidates, including payer-specific buy and bill coverage analysis and appeal strategy.
• Identify and escalate missed PA renewal cases and delegate corrective actions to team members.

Revenue Cycle & Financial Oversight

• Partner with RCM to monitor claims for buy and bill injections, ensuring accurate billing and expected reimbursement levels.
• Review monthly reporting packages, including new buy and bill starts, active buy and bill patient counts, buy and bill conversion metrics, and reconciliation sign-off.
• Identify revenue risk from leakage of these drugs to specialty pharmacy dispensing and develop action plans to address with clinic and pharmacy teams.

Buy And Bill Stewardship & Conversion

• Identify all active patients on buy and bill eligible drugs and manage proactively to maintain in-office administration.
• Conduct systematic review of these patients at renewal to assess buy and bill conversion eligibility and initiate PA and benefits work accordingly.
• Pursue buy and bill alternative pathways at the time of drug denial, working with benefits and PA teams to identify formulary substitutes.
• Coordinate with pharmacy partners and patients to facilitate smooth transitions from specialty pharmacy dispensing to in-office buy and bill.
• Maintain and report on a conversion pipeline, tracking patients by status (candidate, in-process, converted, ineligible).
• Review and verify patient schedules to ensure appropriate drug ordering based on scheduled patient

IG Patient Management

• Oversight and steward IVIG/SCIG patients, maintaining coordination with pharmacy and patient contacts.
• Track patient concentration by location to inform long-term infusion clinic planning and resource allocation.
• Serve as the primary liaison for IG-related coordination issues across clinics, pharmacy, and patient stakeholders.

Qualifications

• Strong understanding of buy and bill reimbursement models and specialty pharmacy operations
• Experience with prior authorization processes and benefits investigation, including payer-specific buy and bill coverage analysis
• Understanding of Revenue Cycle Management and Biologics Billing
• Excellent organizational and project management skills with the ability to manage a regional patient population
• Strong communication skills, both verbal and written
• Creative problem-solving and sound decision-making ability
• Strategic and analytical mindset with keen attention to detail
• Excellent relationship management skills; ability to work collaboratively with internal and external teams
• Ability to lead, train, and motivate a team
• Accountability, adaptability, and discretion
• Ability to travel across assigned region
• Clinical background (clinician preferred)
• PACS certification or at least two years of prior authorization experience
• Experience with specialty biologics, IVIG/SCIG, or infusion therapy management
• Familiarity with Lux Infusion or similar specialty pharmacy coordination platforms
• Ability to analyze data and reports to drive operational decisions

Physical Requirements

• Ability to sit for extended periods and communicate effectively, including speaking and hearing
• Ability to perform repetitive tasks such as typing
• Information processing, memory recall and ability to exercise independent judgment

Why Join AllerVie?

When you join AllerVie Health, you become part of a purpose-driven team dedicated to transforming lives through compassionate allergy care. We recognize and value the experience, perspective, and commitment you bring to our mission. In return, we offer competitive compensation and comprehensive benefits that empower you to thrive. This support enables you to give your best to the patients who count on us every day.

Benefits

• Bi-weekly Pay
• Medical, Dental, and Vision Insurance Plans
• Employer HSA contribution
• Employer-Paid Life Insurance
• Supplemental benefit offerings
• 401(k) Plan with employer match
• Generous PTO and paid holidays