Patient Access Coordinator

Infusion4Health Inc; Brea (CA); On-site; USD 65,904,000 - 77,366,000; Full time

Job summary

Infusion for Health is hiring a Patient Access Coordinator in Brea, CA. The role is full-time onsite with hourly pay in the mid- $20s range, supporting patient access and prior authorizations across insurance programs. You will collaborate with multiple teams to ensure compliant, timely authorizations and accurate documentation.

Expect to manage urgent authorizations and maintain detailed records while upholding company policies and standards in a fast-paced clinical setting.

Qualifications

• At least 2 years experience in infusion or pharmacy prior authorization.
• At least 2 years experience with Medicare, Medicaid, and Managed Care reimbursement.
• Ability to manage multiple priorities within a changing environment with paperless workflow.
• Experience diagnosing, isolating, and resolving complex issues.

Responsibilities

• Ensure timely submission, follow-up and approval of prior authorizations with stakeholders.
• Review information for accuracy and completeness with supporting documents.
• Assist with medical necessity documentation to expedite approvals.
• Collaborate with other departments to obtain prior authorizations/appeals.
• Document interactions with insurance companies or other stakeholders in the system.
• Record all prior authorization information in the patient profile.
• Proactively manage expiring prior authorizations.
• Adhere to the Company's Code of Business Conduct and Ethics and applicable policies.
• Complete duties, projects, and reports timely per leadership direction.
• Perform other duties as assigned.

Skills

Prior Authorization

Medicare/Medicaid knowledge

Multitasking

Problem Solving

Job description

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Patient Access Coordinator

Full Time Brea, CA, US

Salary Range: $23.00 To $27.00 Hourly

Join our team as a Patient Access Coordinator!

Infusion for Health is a referral-based infusion center that services all providers in multiple locations in California, Arizona, Nevada, Washington, Colorado, and Missouri. Our center is unique and offers individual comfortable private rooms for our patients. Our mission is to provide exceptional service in the administration of infusion therapy in a comfortable, patient-focused environment by providing exemplary professional clinical care.

Our company is continuing to grow and we're looking to add a Prior Authorization Specialist to support our patient care operations department.

This is a full-time, 5 days a week position, onsite at our Brea HQ office.

Key Responsibilities:

• Responsible for ensuring timely, accurate submission follow-up and approval of Authorizations. Work with urgency, high-quality and high communication with patients, insurance and additional stakeholders as needed.
• Review the accuracy and completeness of the information requested and ensure that all supporting documents are present
• Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
• Collaborate with other departments to assist in obtaining prior authorizations/appeals
• Document all interactions with insurance companies or other stakeholders within the company system
• Document all prior authorization information, including approval dates, billing units, procedure codes, and prior authorization number in the patient profile
• Proactively work on prior authorizations that are due to be expired
• Conduct job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
• Completes all required duties, projects, and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of the leadership.
• Other duties as assigned

Education and/or Experience Needed:

• At least 2 years experience in infusion or pharmacy prior authorization is required
• At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines
• Ability to effectively handle multiple priorities within a changing environment, emphasizing paperless workflow
• Experience in diagnosing, isolating, and resolving complex issues and recommending and implementing strategies to resolve problems.