Prior Authorization Coordinator, Pharmacy Buisness office, 40hr, Day
Core
Obtains authorization numbers from insurance companies, reviews prior authorization requests for medical necessity, and determines appropriate benefit coverage for general and oncology infusion clinics.
Role type
Prior Authorization Coordinator
Builds
Supports general and oncology infusion clinics by ensuring medication treatment coverage and accurate billing.
Domain
Healthcare / Pharmacy Administration
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Medical secretarial/administrative support, Microsoft Office, internet skills, customer service, team collaboration
Preferred skills
Prior authorization experience in infusion settings, All Scripts, IDX
Responsibilities
Completes prior authorization reviews for infusions, manages authorization renewals to prevent coverage lapses, coordinates authorization processes, performs weekly audits for billing accuracy, maintains shared databases of authorization numbers, assists in maintaining best practices manuals, sets up confidential files and coordinates medical record retrieval.
Seniority
Mid-level, hands-on IC