Prior Authorization Specialist

divh2Prior Authorization Specialist/h2pInfusion for Health is a referral-based infusion center that services all providers in multiple locations in California, Arizona, Nevada, Washington, Colorado, and Missouri. Our center is unique and offers individual comfortable private rooms for our patients. Our mission is to provide exceptional service in the administration of infusion therapy in a comfortable, patient-focused environment by providing exemplary professional clinical care./ppOur company is continuing to grow and were looking to add a Prior Authorization Specialist to support our patient care operations department./ppThis is a full-time, 5 days a week position, onsite at our Brea HQ office./ph3Key Responsibilities:/h3ulliResponsible for ensuring timely, accurate submission follow-up and approval of Authorizations. Work with urgency, high-quality and high communication with patients, insurance and additional stakeholders as needed./liliReview the accuracy and completeness of the information requested and ensure that all supporting documents are present/liliAssist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed/liliCollaborate with other departments to assist in obtaining prior authorizations/appeals/liliDocument all interactions with insurance companies or other stakeholders within the company system/liliDocument all prior authorization information, including approval dates, billing units, procedure codes, and prior authorization number in the patient profile/liliProactively work on prior authorizations that are due to be expired/liliConduct job responsibilities in accordance with the standards set out in the Companys Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards/liliCompletes all required duties, projects, and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of the leadership./liliOther duties as assigned/li/ulh3Education and/or Experience Needed:/h3ulliAt least 2 years experience in infusion or pharmacy prior authorization is required/liliAt least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines/liliAbility to effectively handle multiple priorities within a changing environment, emphasizing paperless workflow/liliExperience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems./liliIntermediate level skills in Microsoft Excel Word/li/ulpThe hourly pay range for this role is expected to be between $24-$27. Actual base pay could vary based on factors including but not limited to experience, subject matter expertise, geographic location where work will be performed, and the applicants skill set. The base pay is just one component of the total compensation package for employees. Other rewards may include an annual cash bonus and a comprehensive benefits package./p/div