Prior Authorization & Scheduling Coordinator - Twin Cities Orthopedics Rheumatology

iHealth; Hudson (WI); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Medical, Dental & Vision plans

Tuition Reimbursement

401(k) Profit Sharing

Employee Assistance Program

Lifetime Fitness Subsidy

Job summary

Revo/ i-Health is seeking a Clinical Care Coordinator to support patient care and administrative tasks in the Rheumatology department. The role is in-person, full-time, with duties including prior authorization management and infusion scheduling across Hudson and Woodbury locations.

The candidate will liaise with providers and patients, ensure insurance requirements are met, and maintain up-to-date knowledge of plan networks. Strong communication and organizational skills are required.

Qualifications

• High school diploma or GED is required.
• Minimum 2 years of prior authorization experience.
• Knowledge of health plan requirements and infusion scheduling is preferred.
• Strong communication, organizational and problem-solving skills are essential.
• Ability to work independently and in a team environment.
• Customer service experience is valued.

Responsibilities

• Manage prior authorizations and scheduling for rheumatology and infusion patients.
• Serve as liaison between providers and patients.
• Obtain benefit, referral and authorization requirements per insurance guidelines.
• Follow up on patient inquiries with providers or insurers as needed.
• Maintain knowledge of health plan requirements and networks.
• Collaborate with providers, clinical staff and insurers to ensure efficiency.

Skills

Prior authorization processes

Infusion scheduling

Communication

Organizational skills

Problem solving

Team collaboration

Customer service

Independent work

Education

High school diploma / GED

Job description

The Clinical Care Coordinator performs a variety of patient care and administrative responsibilities to support patient and providers.

Full-time role working Monday - Friday 8:00 AM - 4:00 PM, in-person position, working in the Rheumatology department with primary duties of Prior Auth and Infusion scheduling, 3 days a week at Hudson and 2 days a week at Woodbury.

Twin Cities Orthopedics is an operating division of Infinite Health Collaborative (i-Health), a group of local medical practices, owned and led by its physicians, on a mission to give patients more control over their healthcare.

Essential Functions:

• Manage prior authorizations and scheduling for rheumatology and infusion patients.
• Provide communication and liaison between providers and patients
• Obtains benefit, referral and/or authorization requirements per insurance guidelines
• Provide follow up to patient inquiries, contacting provider and/or insurance company as necessary
• Maintain a working knowledge of health care plan requirements and health plan networks
• Collaborate with providers, clinical staff, and insurance companies to ensure efficient workflow and patient care.
• Any and all other duties as assigned

Education and Experience Requirements:

• High school diploma/GED or equivalent
• 2 years prior authorization experience
• Medical terminology knowledge strongly preferred
• Strong understanding of prior authorization processes and infusion scheduling.
• Excellent communication, organizational, and problem-solving skills.
• Ability to work independently and as part of a collaborative team.
• Customer service experience

• Actual starting pay will vary based on education, skills, and experience.
• We offer a comprehensive benefits package - to learn more click here.
  • Employees working 30+ hours per week (60 hours per pay period) are eligible for our Medical (w/Maternity Bundle), Dental & Vision plans, as well as Tuition Reimbursement.
  • All employees, regardless of hours, are eligible for 401(k) Profit Sharing, Employee Assistance Program, Lifetime Fitness Subsidy, Car Rental discounts, Home, Auto, & Pet insurance savings programs & more.

Working Conditions:

• Frequently lift up to 50 pounds independently and occasionally up to 100 pounds with assistance.
• Requires the ability to stand, walk, bend, and move continuously throughout the shift.
• Must be able to frequently perform physical activities such as pushing, pulling, and reaching.
• Visual acuity to read electronic and paper documents.
• Auditory ability to participate in phone or video calls clearly.
• Manual dexterity to operate standard office equipment (e.g., computer, phone, printer).

Essential Requirements:

Ability to:

• Comply with company policies, procedures, practices, and business ethics guidelines.
• Comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, etc.)
• Demonstrate prompt and reliable attendance.
• Work at an efficient and productive pace, handle interruptions appropriately, and meet deadlines. Prioritize workload effectively.
• Communicate respectfully and professionally in face-to-face, phone and email interactions. Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions.

Notes

• Revo/ i-Health is an Equal Opportunity Employer. We are committed to fostering an inclusive and accessible workplace. Reasonable accommodation may be provided to enable individuals with disabilities to perform essential job functions. Applicants or employees who wish to request an accommodation may do so by emailing [e-mail]. For more information, please review the Know Your Rights notice from the U.S. Equal Employment Opportunity Commission.
• We participate in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: https://www.e-verify.gov/employees/employee-rights-and-responsibilities
• Please note: This job description is intended to describe the general nature and level of work being performed by individuals assigned to this position. It is not an exhaustive list of all duties, responsibilities, and qualifications required. Revo/ i-Health reserves the right to modify job duties or descriptions at any time, with or without notice, in accordance with applicable laws.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.

For further information, please review the Know Your Rights notice from the Department of Labor.