Authorizations Coordinator JobFarmington, MI 59708

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Why You'll Love This Job

Is responsible for determining the patient's eligibility and obtaining prior authorization for specialty medications, to maintain a professional and courteous relationship with pharmaceutical reps, and to communicate effectively with patients regarding their benefits and the required treatment.  

Responsibilities

  • Utilizes payer guidelines and provides clinical review of prescribed medications; patient lab reports, prior treatments, and payer formularies.
  • Obtains initial and subsequent pre-authorizations for in-house, at-home and facility infusions and medications for new and existing patients.
  • Uploads medication supporting documentation and medical records to payer portals.
  • Initiates and answers patient, colleague, and insurance company calls regarding the prior authorization process and patient financial assistance.
  • Determines patient financial responsibilities and assists patients with finding and securing financial assistance.
  • Schedules nursing visits in compliance with billing requirements.
  • Coordinates shipment of medications from specialty pharmacies.
  • Assists front desk with tasks including, but not limited to, greeting guests, check in/out patients, answering and directing calls, scheduling appointments.
  • Participates in training of new employees and provides feedback on employee’s progress to the Office Manager.
  • Adheres to all policies and procedures as put forth in the Employee Handbook.
  • Provides help and support to co-workers, guests/patients and physicians whenever needed.
  • Maintains a professional appearance.
  • Maintains strict confidentiality.
  • Performs other related duties as assigned.
  • Discusses/Uses appropriate language and topics.

Skills & Qualifications

To perform this job successfully, an individual must have a positive can-do attitude and a genuine empathy for others. Must be able to perform each essential duty satisfactorily, as well as provide excellent guest/patient relations. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:

  • Minimum Education:  High School Diploma or G.E.D.

  • Minimum Work Experience:   One (1) year certificate from college or technical school and three (3) to six (6) months related experience and/or training.

  • Prior Authorization Experience Preferred.

  • Language Skills:  Ability to read and comprehend simple instructions, short correspondence and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients and other employees of the organization. Ability to utilize the telephone in such a manner that all calls are answered within 2 rings, messages are clear and accurate, and whenever possible, calls are to be handled without transferring the patients or asking them to hold for long periods of time. Good computer skills.

  • Mathematical Skills:   Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent.

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