Infusion Insurance and Prior Authorization Coordinator

Job description

Responsibilities The Infusion Insurance and Prior Authorization Coordinator independently manages and strategically evaluates patient referrals for infusion services to determine if insurance and prior authorization criteria are fulfilled to either accept or deny the patient for outpatient infusion services. This position serves as a subject matter expert and uses independent discretion and judgement in interpreting payer policies, medical necessity criteria, and reimbursement requirements. This position ensures proper and timely insurance authorization, answers infusion financial questions for patients and providers, and documents authorization outcomes to guide optimal and timely infusion service management and administration. This position manages uninsured and underinsured patient referrals with patient assistance and charity options. This position serves as a subject matter expert and key operational resource to clinical leadership, revenue cycle leadership, and providers. Qualifications: EDUCATION, EXPERIENCE, TRAINING: Required qualifications: 1. High school diploma or GED2. Critical thinking and decisive judgment on authorization matters with financial and operational signi...