Coordinator - Infusion Authorization

Responsibilities

• Performs Infusion/medication authorization functions for the hospital outpatient infusion departments (or other depts. as assigned).
• Provides leadership critical information concerning outstanding authorizations, physician documentation and communication, nursing documentation and communication and other information concerning outstanding authorizations.
• Works closely with Infusion staff, RN Auditors, Patient Financial Services, and Physician offices to minimize denials and obtain authorizations in a timely manner.
• Maintains professional working relationships with HH employees at all levels.
• Communicates clearly, effectively, and respectfully with patients, physicians, infusion center staff and other personnel within the organization.
• Collaborates with managers to coordinate needs and updates.
• Communicates payer criteria to providers and or patients as requested.
• Serves as a subject matter expert for physicians, administrators, clinical staff, pharmacy staff and third-party payers for issues regarding ambulatory reimbursement requirements and patient assistance programs.
• Uses appropriate communication etiquette with patients, physicians, all internal and external customers.
• Observes policies and procedures.
• Facilitates problem solving with clinical departments, providers, referral sources, insurance companies and authorization staff.
• Assists in the maintenance and communication of changing payer and pharmaceutical information specific to coordination of patient needs, benefits and medical necessity.
• Files patient information received and records medical necessity requirements, in appropriate computer systems per department process and performs data entry of actions and responses to actions per department process.
• Enters complete and accurate notes regarding benefits, authorization, and predeterminations.
• Performs other duties as assigned.

Qualifications

• Associates or 2 years' work related experience in Healthcare Management or related field
• Bachelors Preferred
• Experience 2 years experience obtaining authorizations for medical procedures/treatments including IV infusion of medications, chemotherapy or administration of biologicals or related experience
• 4 years experience obtaining authorizations for medical procedures/treatments including IV infusion of medications, chemotherapy or administration of biologicals Preferred
• Drivers License (DL) - License Driver Licence - Valid And In State Current and valid State of Arizona driver’s license Required
• Certified Professional Coder (CPC) - Certification CCS, or RHIT certification Preferred