Prior Authorization Coordinator

Job Summary

Working full-time in the Pharmacy Business Office, the Prior Authorization Coordinator will obtain authorization numbers from insurance companies, review prior authorization requests for medical necessity, and ensure appropriate benefit coverage for infusion clinics while maintaining a remote work environment.

Key responsibilities:

• Completes prior authorization reviews for general and oncology infusions, researching medical necessity based on patient diagnosis and treatment plans
• Communicates with insurance carriers and internal departments to resolve prior authorization issues and manage incoming patient reports
• Maintains a shared database of prior authorization numbers and participates in performance improvement initiatives to ensure compliance with regulations

Required qualifications:

• High School diploma
• 2-3 years of medical secretarial or administrative support experience
• Proficiency in Microsoft Office and internet skills
• Good customer service skills and ability to work in a team environment
• Preferred: 6-12 months of prior authorization experience in an infusion setting