Prior Authorization Coordinator

Job Description

Job Description

Description:

This is a remote position and must be available to work and participate in training, meetings, and team collaboration during standard Eastern Time business hours. While all qualified candidates will be considered, candidates located in or aligned with the Eastern Time Zone are preferred due to training and operational support needs.  

Job Title: Prior Authorization Coordinator

Location: Remote, but must reside in any of the following states: AR, FL, IL, IN, KY, MO, OH, PA, or TN

FLSA Status: Non-Exempt, Hourly

Travel: No

Work Schedule: Monday - Friday, 8:00 a.m. - 5:00 p.m.

About Family Allergy & Asthma:

Founded in 1979, Family Allergy & Asthma is one of the nation’s leading allergy and asthma practice groups, serving patients across Arkansas, Florida, Illinois, Indiana, Kentucky, Missouri, Ohio, Pennsylvania, and Tennessee. With more than 100 allergists, we are dedicated to delivering high-quality, patient-centered allergy and immunology care. Our comprehensive services include:

• Allergy and asthma evaluation and treatment
• Environmental, food, and drug allergy testing
• Pulmonary function testing
• High-risk food challenges
• Sublingual immunotherapy
• Aspirin desensitization
• Food immunotherapy

Position Summary:

The Prior Authorization Coordinator is responsible for demonstrating knowledge and application of job duties within scope of practice and functions under the direction of the manager(s) and/or Director(s); respectfully interacts with all levels of staff; provides assistance, as needed, during assigned duty hours; participates in department activities; promotes independence; adherence to the attendance policy; encourages socialization; advocates for the quality of life of our patients while maintaining compliance with all applicable laws, regulatory and organizational standards; supports the company’s core values.

Summary of Duties and Responsibilities:

• Works closely with the biologic/specialty medication specialist nurse to help streamline the process’
• Communicates with providers, nurses, managers, and patients to track specialty medications and biologics given or received
• Communicates on the telephone professionally and pleasantly. Efficiently screens and directs calls and make appointments as necessary for the biologics and specialty medication process, if required
• Runs reports to track appointments/biologics inventory and maintains integrity of patient charts
• Collecting all necessary documentation to complete timely and accurate submission of prior authorizations, appeals and scheduling physician peer to peers for biologics and specialty medications, as necessary.
• Interacts with clients, insurance companies, sales representatives, providers, and patients, as necessary
• Maintain and follow HIPAA policies and procedures
• Monitors workflow and databases for outstanding authorization or re-authorizations to ensure timely processing of patients for services, care and billing
• Other relevant duties as assigned by manager

Required Education and Experience:

• High School Diploma or equivalent
• Minimum of 1-3 years of related experience in Biologics/Prior Authorizations
• Knowledge of medical terminology
• Familiarity with EMR systems
• Strong attention to detail and organization skills
• Excellent verbal and written communication skills
• Ability to multitask and manage deadlines in a fast-paced environment
• Proficiency in Microsoft office suite, including excel and outlook

EEO Compliance:

All Family Allergy & Asthma divisions are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. Family Allergy & Asthma divisions are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

Notice:

At Family Allergy & Asthma and all our divisions, our Human Resources department and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at Family Allergy & Asthma and our divisions. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

Pay Transparency:

To encourage pay transparency, promote pay equity, and proactively address regulations, Family Allergy & Asthma and all our divisions will comply with all applicable state or local laws or regulations which require employers to provide wage or salary range information to job applicants and employees. Salary offers may be based on key factors such as education and related experience.