Prior Authorization Pro for Infusion Care

Infusion4Health Inc; Brea (CA); On-site; USD 32,000 - 37,000; Full time

Job summary

Infusion for Health is seeking a Prior Authorization Specialist in Brea, CA to support patient care operations. This full-time, onsite role requires timely submission, accurate documentation, and collaboration with insurers and healthcare teams to expedite approvals.

Applicants should have at least 2 years of infusion or pharmacy prior authorization experience and knowledge of Medicare/Medicaid guidelines. The position emphasizes multi-tasking in a fast-paced environment and adherence to company

Qualifications

• 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.

Responsibilities

• Responsible for ensuring timely, accurate submission follow-up and approval of Authorizations, with urgency, high-quality communication with patients, insurance and stakeholders.
• Review the accuracy and completeness of the information requested and ensure all supporting documents are present.
• Assist with medical necessity documentation to expedite approvals and ensure appropriate follow-up.
• 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.
• Complete duties per leadership direction.
• Other duties as assigned

Job description

Infusion for Health is seeking a Prior Authorization Specialist in Brea, CA to support patient care operations. This full-time, onsite role requires timely submission, accurate documentation, and collaboration with insurers and healthcare teams to expedite approvals.

Applicants should have at least 2 years of infusion or pharmacy prior authorization experience and knowledge of Medicare/Medicaid guidelines. The position emphasizes multi-tasking in a fast-paced environment and adherence to company