Pre-Authorization Navigator — Specialty Meds

CommonSpirit Health; Bremerton (WA); On-site; USD 52,000 - 62,000; Full time

Job summary

Virginia Mason Franciscan Health is seeking a Pre-Authorization Rep to ensure seamless access to prescribed therapies by coordinating with infusion centers, physician offices, and insurance providers. You will manage pre-authorizations for specialty medications and navigate insurance requirements to minimize delays in patient care.

Responsibilities include reviewing patient records in Epic, communicating with medical providers, and partnering with billing to resolve denials.

Qualifications

• Two years of related work experience demonstrating requisite job knowledge and abilities.
• Ability to interpret regulatory guidelines including HIPAA compliance and maintain accuracy in documentation.

Responsibilities

• Monitor work queues and verify insurance coverage to secure necessary authorizations.
• Review patient records in Epic to identify documentation needs and communicate with providers.
• Collaborate with the billing department to resolve insurance denials and delays.
• Stay current on payer requirements, market conditions, and medication availability to support patients.

Skills

Insurance billing

Medical terminology

Job description

Virginia Mason Franciscan Health is seeking a Pre-Authorization Rep to ensure seamless access to prescribed therapies by coordinating with infusion centers, physician offices, and insurance providers. You will manage pre-authorizations for specialty medications and navigate insurance requirements to minimize delays in patient care.

Responsibilities include reviewing patient records in Epic, communicating with medical providers, and partnering with billing to resolve denials.