Biologics Coordinator

AllerVie | Full-Time

Remote role. Preferred locations: VA, DC, MD. Also considering: Birmingham, OH, and Dallas area.

Job Summary:

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. Itoperatesin 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.

Key Responsibilities:

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.
• 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.
• Identifyand escape missed PA renewal cases and delegate corrective actions to team members.
• Partner with RCM tomonitorclaims for buy and bill injections, ensuringaccuratebilling 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.
• Identifyrevenue risk from leakage of these drugs to specialty pharmacy dispensing and develop action plans toaddress withclinic and pharmacy teams.

Buy and Bill Stewardship & Conversion

• Identifyall active patients on buy and bill eligible drugs and manage proactively tomaintainin-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 toidentifyformulary substitutes.
• Coordinate with pharmacy partners and patients tofacilitatesmooth 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 ensureappropriate drugordering based on scheduled patient
• Oversight and steward IVIG/SCIG patients,maintainingcoordination 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 acrossclinics, 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.

• Bi-weekly Pay
• Medical, Dental, and Vision Insurance Plans

AllerVie Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.