Infusion Biologics Coordinator

About the Role

The Infusion Coordinator acts as the liaison between patients, clinical staff, insurance companies, and manufacturer companies. Responsibilities include benefits investigations, obtaining authorizations, enrolling patients in copay assistance, reviewing scheduling, and assisting with claims that have not been fully adjudicated or have been denied. The role supports patient education regarding biologic therapies and maximizes reimbursement through funding programs or provision of infusion medications.

Responsibilities

• Perform all necessary tasks to verify medical benefits, insurance eligibility, and whether referrals are required by the patient’s insurance carrier.
• Ensure that all necessary prior authorizations are obtained before a patient arrives for a scheduled procedure.
• Collaborate with healthcare providers to verify treatment plans, obtain necessary authorizations, and ensure compliance with clinical protocols.
• Communicate with patients, staff, administrators, and operations management in a timely manner.
• Perform other duties as required.

Skills

• Extremely detail-oriented with the ability to read and comprehend specific insurance policies and protocols.
• Basic understanding of CPT and ICD coding and rudimentary medical terminology.
• Excellent judgment and decision-making abilities.
• Strong problem-solving and organizational skills.
• Reliability, accuracy, and efficiency when dealing with patients or third-party payors.
• Excellent verbal and written communication skills.
• Ability to use good judgment in highly emotional and demanding situations.
• Ability to react to frequent changes in duties and volume of work.
• Ability to manage multiple tasks with ease and efficiency.
• Effective interpersonal skills, including the ability to promote teamwork.
• Strong problem-solving skills.
• Maintains confidentiality of sensitive information.

Qualifications

• Knowledge of third-party insurance authorization and billing practices.
• Knowledge of internal billing structure and billing procedures.
• Experience with patient assistance programs.
• High-school diploma or GED; Associate’s degree or higher in health sciences or related field preferred.
• 2 years’ experience in a large medical practice, specialty pharmacy, outpatient infusion center, or hospital performing similar tasks, preferably in infusion therapy or biologics coordination.
• Proficiency in electronic medical records (EMR) systems and scheduling software.
• Proficiency with Microsoft Office products including Word and Excel.

Schedule

This is a full-time hybrid position, Monday through Friday, with a fixed schedule determined by the needs of the organization.

Benefits

• Medical, Dental, and Vision insurance.
• Life Insurance and Voluntary benefits.
• Time-Off Benefits.
• Employee Assistance Program (EAP).
• 401K retirement plan.
• Commuter Benefits.