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Prior Authorization Specialist Infusion4Health Inc Brea, CA Job Details Full-time $23 - $27 an hour 13 hours ago Qualifications Microsoft Word Medicare Managed care Spreadsheets Word embeddings Pre-authorization review for utilization management Medicare regulations Medicaid regulations Medicaid Healthcare reimbursement methods Full Job Description Prior Authorization Specialist Job Description Infusion 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. Our company is continuing to grow and we're looking to add a Prior Authorization Specialist to support our patient care operations department. This is a full-time, 5 days a week position, onsite at our Brea HQ office.

Compensation:

$23-$27/hr DOE +

Benefits Key Responsibilities:

Responsible 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. Review the accuracy and completeness of the information requested and ensure that all supporting documents are present Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed Collaborate with other departments to assist in obtaining prior authorizations/appeals Document all interactions with insurance companies or other stakeholders within the company system Document all prior authorization information, including approval dates, billing units, procedure codes, and prior authorization number in the patient profile Proactively work on prior authorizations that are due to be expired Conduct job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards Completes all required duties, projects, and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of the leadership. Other duties as assigned Education and/or

Experience Needed:

At least 2 years experience in infusion or pharmacy prior authorization is required At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines Ability to effectively handle multiple priorities within a changing environment, emphasizing paperless workflow Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems. Intermediate level skills in Microsoft Excel & Word Monday to Friday 40