Infusion and Medication Authorization Coordinator

Responsibilities

• Contacts patients about financial costs before treatment is scheduled.
• Works with pharmacy department for medical necessity information.
• Uses practice software and authorization software to gather patient insurance information and clinical documentation.
• Documents all conversations with patients and insurance companies in the patient’s electronic record.
• Communicates approvals to infusion staff for scheduling purposes.
• Runs reports for upcoming infusion appointments to investigate benefits and determine eligibility.
• Ensures expiring authorizations are renewed for patients.
• Enrolls patients in Co-Pay assistance programs if eligible.
• Communicates with patients regarding their coverage expiration to ensure timely re-enrollment.
• Demonstrates knowledge of insurances, drug formularies, and rheumatology treatment.
• Knowledge of prior authorization, workflows, payer reimbursements, insurance benefits, ICD and CPT codes.
• Obtains free drugs for patients without necessary coverage.
• Aids the infusion scheduler in ordering free drug medications.

Qualifications

• High school diploma or GED equivalent.
• 2 years of relevant experience in infusion authorization or billing, medical insurance, or medical billing.