Job Overview We are seeking a dedicated and detail-oriented Prior Authorization Coordinator - Injectables to join our healthcare team. This vital role involves managing the authorization process for injectable medications, ensuring timely approval from insurance providers, and facilitating seamless patient care. The ideal candidate will possess strong knowledge of health insurance policies, medical coding, and electronic health records management, with a commitment to maintaining clinical confidentiality and delivering excellent customer service. The coordinator will serve as a key liaison between healthcare providers, insurance companies, and patients to streamline prior authorization procedures and optimize treatment workflows. Responsibilities Review medical documentation and verify insurance coverage for injectable treatments in accordance with health insurance policies and managed care guidelines. Prepare and submit prior authorization requests accurately utilizing appropriate CPT (Current Procedural Terminology) ICD-10 Track authorization statuses diligently, follow up with insurance carriers as needed, and resolve any issues that may delay approval Maintain comprehensive medical records and ensure compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations to protect patient confidentiality. Collaborate closely with healthcare providers to gather necessary clinical information and ensure all documentation meets payer requirements. Utilize Electronic Medical Records (EMR/EHR) systems effectively for documentation, communication, and record-keeping purposes. Stay informed about changes in health insurance policies, coding updates, and industry best practices to enhance the efficiency of the authorization process. Skills Strong understanding of HIPAA regulations to uphold patient privacy and data security standards. Proficiency in medical terminology, Experience with insurance verification processes and prior authorization procedures within managed care environments. Experience with Epic (EMR) Demonstrated ability to provide exceptional customer service while managing sensitive clinical information with discretion. Familiarity with clinical confidentiality policies and medical records management protocols to ensure compliance at all times.

What We Offer:

Health, dental, and vision insurance Paid time off and holidays Supportive team environment Join our team as a Prior Authorization Coordinator - Injectables to play a crucial role in facilitating efficient patient care through accurate authorization management while adhering to industry standards and regulatory requirements. Your expertise will help streamline processes that directly impact patient outcomes and organizational success.

Pay:

$23.00 - $24.00 per hour

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance

Work Location:

In person