Prior Authorization Coordinator

Job Summary

To support a Specialty Infusion Pharmacy, the full-time Prior Authorization Coordinator will manage prior authorizations, copay assistance, and insurance verification while working remotely from the USA.

Key responsibilities

• Verify insurance benefit information and maintain detailed knowledge of insurance plans to maximize benefits
• Generate prior authorization expiration reports and review clinical documents for submission purposes
• Provide exceptional customer service while documenting insurance coverage and notifying patients about their financial responsibilities

Required qualifications

• At least 2 years of home infusion specialty pharmacy experience, including prior authorizations
• High school diploma or equivalent required
• Previous medical and pharmacy benefit experience is required
• Experience initiating and securing prior authorizations, pre-determination, and appeals
• Ability to interpret payor contract fee schedules based on NDC and HCPCS units