Authorization Specialist

Responsible for prior authorizations and reauthorizationResponsible for tracking authorization status and adding to all necessary systems Responsible for confirming medical necessityNegotiates single case agreements for out of network insurance cases Establish and execute systems for maximizing insurance coverage and reimbursementCoordinates with clinics and providers to ensure all necessary documentation is being tracked and logged to allow for reauthorization and continued care Works with outside pharmacies for Spravato authorization and coverageCollaborates and facilitates needed changes to the plan of care/ level changesContinuously checks medical policies for changes to medical criteria needed for servicesAssist patients in enrolling into the Spravato REMS program and Spravato Savings Program, JPAP as neededSchedule patients for their Spravato induction phasePatient communicationExhibit a high level of professionalism, empathy, and positivity