Authorization Coordinator I

Nufactor, Inc.; Temecula (CA); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Medical Insurance

401(k) Profit Sharing Retirement Plan

Paid Holidays/Vacation/Sick Days

Job summary

Nufactor, Inc. is seeking an Authorization Coordinator responsible for maintaining authorizations for all active patients. The role includes initiating re‑authorization requests and ensuring all deliveries are verified prior to shipping.

The ideal candidate will have strong organizational skills, a detail orientation, and effective communication abilities. Experience in healthcare settings is preferred.

Qualifications

• Must have strong organizational skills.
• Detail-oriented with proven prioritization ability.
• Effective verbal and written communication skills.

Responsibilities

• Initiates re-authorization process for patients.
• Monitors re-authorizations and updates all necessary parties.
• Communicates benefit changes to patients.

Skills

Strong organizational skills

Detail orientation

Effective verbal communication skills

Ability to work independently

Education

High School diploma or equivalent

Tools

Microsoft Office

Job description

The Authorization Coordinator is responsible for maintaining authorizations for all active patients with NuFACTOR. This includes initiating all re‑authorization requests at least 30 days in advance and ensuring all deliveries are properly verified prior to shipping.

Essential Functions and Duties

• Initiates the re‑authorization process by gathering relevant data from the physician’s office and properly submitting re‑authorizations to avoid delays in treatment.
• Monitors re‑authorizations in NuFACTOR system of record Authorization tracking and works 30 days ahead of expiration date.
• Notifies proper departments of any issues or updates relating to coverage or authorization.
• Annually determines patient’s financial obligation, out‑of‑pocket expense and copays.
• Communicates with patients on any benefit changes or changes to their financial obligations.
• Enters all communications and updates in the NuFACTOR system of record notes while working the re‑authorizations for active patients.
• Answers telephones utilizing appropriate etiquette and speaks to referral sources, patients, family members, clinicians and payors.
• Complies with all NuFactor policies and procedures and compliance requirements when engaging in activities related to the company.
• Adheres specifically to all company policies and procedures, Federal and State regulations, and laws.
• Displays dedication to position responsibilities and achieves assigned goals and objectives.
• Always represents the Company in a professional manner and appearance.
• Understands and internalizes the Company’s purpose.
• Displays loyalty to the Company and its organizational values.
• Displays enthusiasm and dedication to learning how to be more effective on the job and share knowledge with others.
• Works effectively with co-workers, internal and external customers and others by sharing ideas in a constructive and positive manner; listens to and objectively considers ideas and suggestions from others; keeps commitments; keeps others informed of work progress, timetables, and issues; addresses problems and issues constructively to find mutually acceptable and practical business solutions; addresses others by name, title, or other respectful identifier, and respects the diversity of our workforce in actions, words, and deeds.
• Complies with the policies and procedures stated in the Injury and Illness Prevention Program by always working in a safe manner and immediately reporting any injury, safety hazard, or program violation.
• Ensures conduct is consistent with all Compliance Program Policies and procedures when engaging in any activity on behalf of the company. Immediately reports any concerns or violations.
• Other duties as assigned.

Education, Knowledge, Skills and Experience

Required Education

• High School diploma or equivalent required.

Preferred Knowledge

• One (1) year health care related experience in a pharmacy, home healthcare, infusion related setting or hospital is preferred.

Preferred Experience

• Benefit verification and prior authorizations for specialty medications.

Required Skills

• Must have strong organizational skills.
• Must have a detail orientation and the proven ability to prioritize work.
• Must have effective verbal and written communication skills.
• Must have the ability to work with limited supervision and as part of a team.
• Sound decision‑making abilities.

Preferred Skills

• Knowledge of medical and pharmacy terminology and calculations, general pharmacy dispensing requirements, including identification of items requiring prescription and valid prescribing data.
• Excellent verbal and written communication skills and the ability to interact effectively with patients, co‑workers and management.
• Ability to work with a high degree of accuracy in an organized, detail oriented manner with appropriate follow‑up when required.
• Ability to communicate effectively and at the appropriate level with healthcare professionals and peers.
• Ability to prioritize work and make decisions independently and effectively, often quickly in response to dynamic patient needs, with limited supervision and direction, except where required/restricted by law.
• Working knowledge of state, federal and Joint Commission guidelines/regulations/laws.
• Ability to exercise discretion and maintain confidentiality to the level of required HIPAA standards.
• Ability to use and understand Microsoft Office skills and internet technologies.

Professional Certification

None.

Physical Requirements

Vision, hearing, speech, movements requiring the use of wrists, hands and/or fingers. Must have the ability to view a computer screen for long periods and the ability to sit for extended periods. Must have the ability to work the hours and days required to complete the essential functions of the position, as scheduled. Must have the ability to lift and maneuver items of at least 20 lbs. Working condition include normal office setting.

Mental Demands

Learning, thinking, concentration and the ability to work under pressure, particularly during busy times. Must be able to pay close attention to detail and be able to work as a member of a team to ensure excellent customer service. Must have the ability to interact effectively with co‑workers and customers, and exercise self‑control and diplomacy in customer and employee relations situations. Must have the ability to exercise discretion as well as appropriate judgment when necessary. Must be proactive in finding solutions.

Direct Reports

No.

EEO Statement

FFF Enterprises and Nufactor are an equal opportunity employer and prohibits discrimination and harassment based on the following characteristics: race, color, religion, national origin, physical or mental disability, gender, age (40 years and over), qualified veteran and any other characteristic protected by state or federal anti‑discrimination law covering employment. These categories are defined according to Government Code section 12920. The Company prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics.

Employee Benefits Available for FFF Enterprises Team Members

• Medical Insurance
• Vision Discount Program
• Vision Insurance Plan
• Health Savings Account (HSA)
• Flexible Spending Account (FSA)
• Dependent Care Flexible Spending Account
• Employee Assistance Program (EAP)
• Group Life and AD&D
• Voluntary Supplemental Life Insurance Plans
• Short Term Disability
• Long Term Disability Income Protection
• 401(k) Profit Sharing Retirement Plan - Discretionary Match
• Discretionary Bonus
• Supplemental Insurance Plans
• Prepaid Legal/Identity Theft Plan
• Paid Holidays/Vacation/Sick Days
  • Seven (7) Paid Holidays, Two (2) Week Vacation, Five (5) Sick Days, and One (1) Float Day for CA, NC, and TX
  • All Other States Receive One Hundred Twenty (120) Hours of PTO
• Tuition Reimbursement Program
• Notary Services
• Employee Referral Bonus
• Corporate Individual Travel Program

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)