Appeals Coordinator (1-2 years exp of appeals working w/ pre-authorization or authorization tea[...]

BioPlus Specialty Pharmacy; Florida; On-site; USD 40,000 - 60,000; Full time

Benefits offered by this job

Competitive compensation packages

Healthcare benefits

401(k) plan

Growth potential

Job summary

BioPlus Specialty Pharmacy in Florida is seeking an Appeals Coordinator to manage appeals by gathering necessary information and submitting it to insurance companies. The ideal candidate will have at least one year of experience in a similar role, along with knowledge of medical terminology.

The role requires effective communication with prescribers and insurance companies, demonstrating BioPlus's commitment to increasing access to care. BioPlus offers competitive compensation, healthcare, and 401(k) options.

Qualifications

• At least 1 year of experience working with appeals, prior authorizations, or billing.
• Specialty pharmacy experience preferred.

Responsibilities

• Gather all information required on an appeal and submit it to insurance companies.
• Verify the information needed by the plan for an appeal.
• Notify appropriate staff of approved/denied medications.

Skills

Medical terminology knowledge

Ability to liaise between departments

Professional image

Education

High School Diploma or Equivalent

Job description

Appeals Coordinator (1-2 years exp of appeals working w/ pre-authorization or authorization teams w/ knowledge of denial process)

• Full-time

As one of the largest and most respected specialty pharmacies, BioPlus creates a meaningful difference to our patients, prescribers, payers, and pharmaceutical partners.

Our 2- Hour Patient Acceptance Guarantee gives a quick response to prescribers and patients for critical, time-sensitive treatments. As we continue to grow,we need exceptionally talented, bright, and driven people. If you would like to help uscontinue tobe theinnovativeleader in our industry, this is your chance to join our team.

The Appeals Coordinator is responsible for gathering all information required on an appeal, writing, and submitting the appeal to insurance company and for all follow up phone calls and documentation of these appeals.

Responsibilities

Confirm prescriber/ patients request to appeal.

Verify the information needed by the plan for an appeal and where to submit.

Gather all necessary information from prescriber office to complete the appeal.

• Responsible for writing the letter of appeal.

Notifying appropriate staff of approved/denied medications.

Process/reverse online claims as required.

Responsible for maintaining required spreadsheets if applicable.

Responsible for all follow up phone calls to the insurance company or prescriber office for status of appeal or request for additional information.

Responsible for all documentation of appeal statuses into CPR+ progress notes.

Update sales staff with pertinent information.

Participate and perform other duties as assigned by leadership.

Skills & Abilities

Demonstrate the BioPlus C.A.R.T. values.

Competence

Accountability

Respect

Trust

Knowledge of medical terminology.

Ability to work cooperatively and be a liaison between departments when needed.

Professional Image

QUALIFICATIONS & ABILITIES:

High School Diploma or Equivalent.

At least 1 year experience working with appeals, prior authorizations, or billing.

Specialty pharmacy experience preferred.

BioPlusoffers competitive compensation packages includinghealth care, 401(k),growthpotential, and a challenging and exciting work environment.

BioPlus is an Equal Opportunity Employer.