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Why You'll Love This Job

Position Summary: The person in this position will be responsible for monitoring incoming patient orders and gathers information needed to complete pre-certifications and pre-authorization for specialty biologic medications, coordinating shipments with specialty pharmacies, scheduling patient appointments all under the direction of Biologic Program Manager.

Licensure/Certification/Registration: None

Education/Qualifications:

High school diploma or general education degree (GED) is required

  • Three to five years of experience, preferably in a healthcare setting
  • Familiar with medical terminology
  • Experience with prior authorization submission through cover my meds preferred
  • Insurance verification experience preferred
  • Excellent communication skills, both written and oral
  • Proficient computer skills including word processing, and data entry, excel
  • Must have ability to communicate professionally and effectively with management, co-workers, hub personnel, as well as vendors and other third parties

 

Job Responsibilities:

  • Communicate professionally and effectively with management, co-workers, hub personnel, as well as vendors and other third parties
  • Contact insurance carriers to verify patient’s insurance eligibility, benefits, and requirements
  • Request, track and obtain pre-authorization from insurance carriers prior to services being performed
  • Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations
  • Communicate any insurance changes or trends among team
  • Maintains a level of productivity suitable for the department
  • Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format
  • Other duties as assigned

Job Type: Full-time

 

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