Prior Authorization Specialist Infusion and Pharmacy Expert

Infusion4Health Inc; Brea (CA); Presencial; USD 23.000 - 27.000; Jornada completa

Descripción de la vacante

Infusion for Health is seeking a Prior Authorization Specialist in Brea, CA. This full-time, onsite role supports the patient care operations department and focuses on timely submission and follow-up of authorizations with insurers.

Ideal candidates have 2+ years in infusion/pharmacy prior authorization, familiarity with Medicare/Medicaid guidelines, and strong multitasking in a paperless environment. Onsite work at Brea HQ is required.

Formación

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

Responsabilidades

• Ensure timely, accurate submission, follow-up, and approval of authorizations with patients, insurers and stakeholders as needed.
• Review accuracy and completeness of 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 obtain prior authorizations/appeals.
• Document all interactions with insurance companies or other stakeholders in the company system.
• Document all prior authorization information, including approval dates, billing units, procedure codes, and PA numbers in the patient profile.
• Proactively work on authorizations due to expire.
• Complete duties per Code of Business Conduct, policies and procedures, and applicable laws.
• Other duties as assigned.

Descripción del empleo

Infusion for Health is seeking a Prior Authorization Specialist in Brea, CA. This full-time, onsite role supports the patient care operations department and focuses on timely submission and follow-up of authorizations with insurers.

Ideal candidates have 2+ years in infusion/pharmacy prior authorization, familiarity with Medicare/Medicaid guidelines, and strong multitasking in a paperless environment. Onsite work at Brea HQ is required.