Impactful Benefits and Prior Authorization Coordinator

Wellstar Health System; Augusta (GA); On-site; USD 38,000 - 52,000; Full time

Job summary

Wellstar Health System in Georgia seeks an Enhanced Benefits Coordinator to serve as the hub for prior authorizations across key service lines. You will obtain and validate insurance and financial information, secure precertifications, and provide benefits overviews to patients before treatment.

The role involves front-line contact with patients, families, providers, nurses and pharmacies, coordinating with medication assistance programs and pharmacy benefits to ensure timely delivery.

Qualifications

• High school diploma or GED required; bachelor's degree preferred.
• Pharmacy technician license (PHT) required.
• 1+ year Pharmacy Technician experience in enhanced benefits or medical office.
• 2+ years Pharmacy Technician experience preferred in enhanced benefits or medical office.

Responsibilities

• Screens, processes, and completes prior authorization through medical benefits and pharmacy benefits.
• Follows-up with patients, providers, and insurance plans on refills and reauthorizations.
• Processes infusion/injection appointments through WMCG IT platforms.
• Coordinates with Medication Assistance Coordinators for specialty medications and shipping related to patient medications.
• Collaborates with Pharmacy Department for performance improvement, customer service, and quality assurance.
• Performs other duties as assigned
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Skills

Communication

Organizational skills

Prioritization

Time management

Medical terminology

Insurance claims

Prior authorizations

Education

High School Diploma / GED

Bachelor's degree preferred

Tools

Microsoft Office

Job description

Wellstar Health System in Georgia seeks an Enhanced Benefits Coordinator to serve as the hub for prior authorizations across key service lines. You will obtain and validate insurance and financial information, secure precertifications, and provide benefits overviews to patients before treatment.

The role involves front-line contact with patients, families, providers, nurses and pharmacies, coordinating with medication assistance programs and pharmacy benefits to ensure timely delivery.