Infusion Authorization Coordinator

Responsibilities

• Performs Infusion/medication authorization functions for the hospital outpatient infusion departments.
• Reviews medical records for submission to insurances, abstracting information from patient medical records.
• Ensures medical necessity is met for all chemotherapy and non-chemotherapy infusion drugs administered.
• Obtains approval, authorization, and/or predetermination for all chemotherapy and non-chemotherapy infusion drugs administered.
• Communicates clearly, effectively, and respectfully with patients, physicians, infusion center staff, and other personnel within the organization.
• Coordinates needs and updates manager.
• Provides results of the authorizations and/or predeterminations.
• 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.
• Enters complete and accurate notes regarding benefits, authorization, and predeterminations.

Requirements

• Bachelor's Degree - Preferred
• Associate's Degree or 2 years' work related experience in Healthcare Management or related field - Required
• 4 years experience obtaining authorizations for medical procedures/treatments including IV infusion of medications, chemotherapy or administration of biologicals - Preferred

Qualifications

• Valid and in state current and valid State of Arizona driver’s license - Required