Infusion Authorization Coordinator Per Diem

Davita Inc.; Scottsdale (AZ); Remote; USD 45,000 - 60,000; Full time

Job summary

A leading healthcare organization is seeking an authorization specialist to manage infusion treatment authorizations, ensuring medical necessity and compliance with payer criteria. The candidate will work from home, assisting with critical documentation while collaborating with healthcare providers to minimize claim denials.

Benefits

Diverse benefits portfolio for team members

Robust training initiatives

Qualifications

• Experience in obtaining medical procedure/treatment authorizations, including IV infusions, chemotherapy, or biologicals (2 years required).
• Preferred certifications: CPC, CCS, or RHIT.

Responsibilities

• Manage prior authorization processes for infusion clinic patients and ensure payer criteria are met.
• Maintain relationships and communicate effectively with all stakeholders.

Skills

Communication

Problem Solving

Attention to Detail

Education

Bachelor's Degree

Associate's Degree or 2 years related healthcare management experience

Job description

Overview

Looking to be part of something more meaningful? At HonorHealth, you'll be part of a team creating a multi-dimensional care experience for our patients. You'll have opportunities to make a difference through programs like our Ambassador Movement and robust training initiatives. HonorHealth offers a diverse benefits portfolio for full-time and part-time team members, designed to help you and your family live your best lives. Learn more at honorhealth.com/benefits. Join us as we go beyond expectations and transform healthcare together.

HonorHealth is one of Arizona's largest nonprofit healthcare systems, serving a population of five million in the greater Phoenix area. Our network includes six acute-care hospitals, a comprehensive medical group with primary, specialty, and urgent care, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, and community services. With nearly 17,000 team members, 3,700 affiliated providers, and close to 2,000 volunteers, we strive to exceed traditional healthcare standards to improve community health across Arizona. More at HonorHealth.com.

Responsibilities

Job Summary: Under leadership guidance, performs infusion/medication authorization functions in outpatient infusion departments. Provides critical information regarding outstanding authorizations, documentation, and communication with physicians, nurses, and other staff. Responsible for denial prevention by securing authorizations and ensuring medical necessity for each infusion treatment, safeguarding financial goals. Collaborates closely with infusion staff, RN auditors, Patient Financial Services, and physician offices to minimize denials and obtain timely authorizations. This is a work-from-home role, with requirements to attend staff meetings and training at NSSC, including initial training for 6 months to 1 year.

Essential Functions:

• Manage prior authorization processes for infusion clinic patients, including reviewing medical records, abstracting treatment details, and ensuring payer criteria are met prior to treatment. Obtain approvals for chemotherapy and non-chemotherapy infusions. Maintain professional relationships and communicate effectively with all stakeholders. Provide formulary assistance and serve as a subject matter expert on reimbursement and patient assistance programs. Conduct outbound and inbound calls to support patients and providers, responding promptly and respectfully to concerns.
• Facilitate problem-solving with clinical departments, providers, insurers, and authorization staff. Keep payer and pharmaceutical information updated to coordinate patient benefits and medical necessity.
• Record and file patient information, document benefits and authorizations accurately, and perform data entry as per department procedures. Perform additional duties as assigned.

Education

• Bachelor's Degree - Preferred
• Associate's Degree or 2 years related healthcare management experience - Required

Experience

• At least 2 years' experience obtaining medical procedure/treatment authorizations, including IV infusions, chemotherapy, or biologicals - Required
• Preferred: 4 years' experience in similar authorization roles

Licenses and Certifications

• Preferred: CPC, CCS, or RHIT certification
• Required: Valid Arizona driver's license