Biologics Coordinator

Paycom - ATS; Albuquerque (NM); On-site; USD 52,000 - 75,000; Full time

Job summary

Allergy Partners seeks a Biologics Coordinator to ensure proper billing for biologics and adherence to company guidelines. You will review charges, participate in rebate programs, and support prior authorizations and education across hubs and practices.

The role emphasizes accuracy, HIPAA compliance, and communication with the Central Billing Office. Ideal candidates have healthcare billing experience, strong attention to detail, and proficient computer skills, including Excel, to manage billing

Qualifications

• High school diploma required.
• 3–5 years of healthcare experience preferred.
• Experience reviewing biologics billing charges and insurance submissions.
• Strong communication and data-entry skills; proficient with computer systems.

Responsibilities

• Ensure biologics billing follows Allergy Partners guidelines and centralized policies.
• Review biologics charges prior to insurance submission and ensure accuracy.
• Assist in education to hubs and practices about billing procedures and payer restrictions.
• Support prior authorizations and re-certifications processes and provide timely updates to the Central Billing Office.
• Maintain confidentiality and comply with HIPAA and other regulatory guidelines.

Skills

Healthcare billing

Attention to detail

Excellent communication

Independent worker

Organizational skills

HIPAA compliance

Education

High school diploma

Tools

Excel

Job description

The Biologics Coordinator will assure the procedure for proper billing of biologics is followed according to Allergy Partners biologics billing guidelines. Duties include but are not limited to establishing specialized rebate and discount program participation, reviewing biologics charges prior to being submitted to insurance, provide follow-up and training as well as process improvement and communication to the Central Billing Office as well as the hubs. General oversight of centralized prior authorizations and re-certifications as well as assist with guidance to hubs related to patient assistance programs and education. Remain in compliance with insurance guidelines and Allergy Partners biologics policy and procedures.Responsibilities include, but are not limited to, the following:Accurately review biologics charges from Waystar and database system in a timely mannerAbility to be very detailed in all tasksWork closely with hub personnel and Biologics Team to ensure that all biologics billing is entered into database according to Allergy Partners guidelinesEfficiently obtain information from account reimbursement specialists, practice managers, and insurance companies to identify changes in billing guidelines, and communicate changes in centralized locationReport regularly on statistics of charges receipts and adjustments as well as exceptions and problem areas and maintain accurate record of changes and education of proper procedureBecome well versed on biologics billing as well as becoming familiar with different insurance payers limitations, exclusions, or other restrictionsAssist in education to the practices including registration for Allergy Partners rebate and discount programsProvide general oversight of prior authorization process as well as re-certificationAbility to work successfully under pressureAssist hubs as needed with flexibility and willingness and accurate informationIdentify issues promptly, and communicate to proper personnelProvide status quickly and accurately of tasks at hand such as outstanding claims to be reviewed before filing as well as statistics on improper process and procedure and training providedHelp ensure profit of biologics billing and report regularly to appropriate personnel by identifying at risk items in the processComplete ad-hoc projects and other duties as requestedDemonstrates professionalism and promotes positive interpersonal relations with all internal and external business contacts, representing corporation in a positive manner, displaying personal commitment to achieving the goals and objectives of the corporationOtherMaintains patient confidentiality, complies with HIPAA and compliance guidelines established by the practice by keeping information confidential.Maintains detailed knowledge of practice management and other computer software (i.e. Excel) as it relates to job functions.Attends OSHA, HIPAA, and OIG training programs as required.Attends all meetings as requested including regular staff meetings.Attends Medicare and other continuing education courses as requested. Pursue and participate in education to remain current with changes in the Healthcare industry.Performs any additional duties as requested by Manager / Supervisor.Completes all assigned AP training (such as CPR, OSHA, HIPAA, Compliance, Information Security, others) within designated timeframes.Complies with Allergy Partners and respective hub/department policies and reports incidents of policy violations to a Supervisor/Manager/Director, Department of Compliance & Privacy or via the AP EthicsPoint hotline.Supervisory ResponsibilitiesThis job has no supervisory responsibilities.Typical Physical DemandsPhysical demands are moderate with occasional lifting of items weighing approximately 20-30 pounds. Position requires prolonged sitting, some bending, stooping, and stretching. Good eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is also required. Employee must have normal range of hearing and vision must be correctable to normal range to record, prepare, and communicate appropriate reports.Typical Working ConditionsNormal office environment. Occasional evening or weekend work.The salary range posted for this position is the national average; however, actual compensation may vary depending on geographic location, job-related knowledge, skills, and experience.EDUCATIONAL REQUIREMENTS:High school diploma. 3 years healthcare or related experience preferred.QUALIFICATIONS AND EXPERIENCEThree to five years of experience, preferably in a healthcare settingExcellent communication skills, both written and oralProficient computer skills including word processing, and data entryMust have ability to communicate professionally and effectively with management, co-workers, hub personnel, as well as vendors and other third partiesDetail oriented with the ability to accurately identify payer restrictions while reviewing biologics charges prior to insurance submission as well as updating Practice Management System with any changesPrecise instructions to hubs related to incorrect biologics billing processesAbility to work independently and stay focused on the task at handStrong organizational skills