Infusion for Health is a referral-based infusion center that services all providers in multiple locations in California, Arizona, Nevada, Washington, Colorado, and Missouri. Our center is unique and offers individual comfortable private rooms for our patients. Our mission is to provide exceptional service in the administration of infusion therapy in a comfortable, patient-focused environment by providing exemplary professional clinical care.
Our company is continuing to grow and we're looking to add a Prior Authorization Specialist to support our patient care operations department.
This is a full-time, 5 days a week position, onsite at our Brea HQ office.
Compensation: $23-$27/hr DOE + Benefits
Key Responsibilities:
Responsible for ensuring timely, accurate submission follow-up and approval of Authorizations. Work with urgency, high-quality and high communication with patients, insurance and additional stakeholders as needed.
Review the accuracy and completeness of the information requested and ensure that all supporting documents are present
Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
Collaborate with other departments to assist in obtaining prior authorizations/appeals
Document all interactions with insurance companies or other stakeholders within the company system
Document all prior authorization information, including approval dates, billing units, procedure codes, and prior authorization number in the patient profile
Proactively work on prior authorizations that are due to be expired
Conduct job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
Completes all required duties, projects, and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of the leadership.
Other duties as assigned
Education and/or Experience Needed:
At least 2 years experience in infusion or pharmacy prior authorization is required
At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines
Ability to effectively handle multiple priorities within a changing environment, emphasizing paperless workflow
Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems.
Intermediate level skills in Microsoft Excel & Word
Monday to Friday
40
Numbers & Facts
Location
Brea, CA
Salary
$23–$27 Per Hour
Skills
Billingunmatched
Business Ethicsunmatched
Clinical Medicineunmatched
Corporate Complianceunmatched
Documentationunmatched
Federal Laws and Regulationsunmatched
Healthcare Reimbursementunmatched
Identify Issuesunmatched
Insuranceunmatched
Intravenous Therapiesunmatched
Leadershipunmatched
Managed Careunmatched
Medicaidunmatched
Medical Assistanceunmatched
Medical Treatmentunmatched
Medicareunmatched
Microsoft Excelunmatched
Microsoft Wordunmatched
Multitaskingunmatched
Organizational Skillsunmatched
Patient Careunmatched
Pharmacyunmatched
Problem Solving Skillsunmatched
Reimbursement Guidelinesunmatched
State Laws and Regulationsunmatched
Time Managementunmatched
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