Remote Biologics Insurance Specialist – Authorizations

National Jewish Health; Denver (CO); Remote; USD 31,000 - 41,000; Full time

Benefits offered by this job

Medical coverage

Paid time off

Tuition reimbursement

403(b) retirement plan

Job summary

National Jewish Health in Denver, CO seeks a Biologics and Medications Insurance Specialist to verify insurance coverage and obtain authorizations for biologics, infusion, and other injectables. You will be the primary contact for insurance questions and coordinate with the Clinic to ensure timely approvals.

The role requires healthcare experience (3+ years), familiarity with insurance plans, and collaboration with the Patient Financial Counseling Office to address high co-pays or coverage gaps.

Qualifications

• High School Diploma or equivalent required; Associate’s degree preferred.
• Minimum of 3 years of healthcare experience; LPN/Medical Assistant/Pharmacy Technician preferred.
• No special training, certification or licensure required.

Responsibilities

• Verify insurance coverage and obtain appropriate authorizations for scheduled biologics, infusion and injectable medications.
• Serve as point of contact for authorizations and related insurance questions.
• Review and complete authorizations and referrals daily to meet deadlines and coordinate with Clinic.
• Notify Patient Financial Counseling Office of gaps in coverage or high cost shares prior to services.
• Document authorizations or denials in the appropriate systems per protocol.
• Educate clinical team on patient insurance requirements and limitations.
• Coordinate the authorization appeal process when not medically necessary.

Skills

Insurance verification

Authorization processing

Data entry

Patient communication

Teamwork

Time management

Problem solving

Customer service

Education

High school diploma or equivalent

Associate’s degree preferred

Job description

National Jewish Health in Denver, CO seeks a Biologics and Medications Insurance Specialist to verify insurance coverage and obtain authorizations for biologics, infusion, and other injectables. You will be the primary contact for insurance questions and coordinate with the Clinic to ensure timely approvals.

The role requires healthcare experience (3+ years), familiarity with insurance plans, and collaboration with the Patient Financial Counseling Office to address high co-pays or coverage gaps.