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Biologics & Prior Authorization Coordinator

MIDSTATE SKIN INSTITUTE, LLC
Posted 19 days ago, valid for 21 days
Location

Ocala, FL 34483, US

Salary

Competitive

Contract type

Full Time

Health Insurance
Paid Time Off

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Sonic Summary

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  • The Biologics/Prior Authorization Coordinator is a full-time position with eligibility for health insurance, paid time off, and a 401k plan.
  • Candidates must have a high school diploma and prior experience in a medical office or healthcare facility, with knowledge of biologics and health insurance processes.
  • The role involves managing patient prescriptions, communicating with various stakeholders, and completing prior authorizations and appeals as necessary.
  • The position requires excellent time management skills and the ability to multitask in a fast-paced office environment.
  • The salary for this position is competitive, though specific figures are not mentioned, and prior experience in the field is preferred.
Biologics/Prior Authorization Coordinator Job Description
Summary: This is a full-time position. This position is eligible for health insurance, paid time off, 401k, etc. This position reports to the Practice Manager as their direct supervisor.

Essential Functions and Responsibilities
  • Managing a patient’s journey from prescription to drug acquisition
  • Navigates the complexities of patient access on behalf of those prescribed biologics
  • Supports doctors, patients and Specialty Pharmacy through a variety of tasks related to patient prescriptions including status and delays
  • Communicates with patients, insurance providers, physicians and other staff as needed
  • Completes enrollment forms and submits prior authorizations for Specialty Medications
  • Reviews benefit verifications and expected costs with patients
  • Writes appeals and letters of medical necessity as needed and/or works with Specialty Pharmacy to complete
  • Directs patient assistance and bridge programs
  • Appropriately interacts with patients, providers, and other staff
  • Responds to patient phone calls and provider tasks in timely manner
  • Full documentation of all communications
  • Coordinates efforts of specialty pharmacies and manufacturer HUBs
  • Completes all other Prior Authorization regarding other medications
  • Organizes, processes and uploads incoming faxes that pertain to biologics and/or prior authorizations
  • Submits refills for biologic medications
  • And other duties/tasks as assigned by management

Qualifications
Required:
  • High school diploma or equivalent
  • Prior experience in a medical office or other healthcare facility
  • Knowledge of biologics and other prescriptions
  • Experience and Knowledge with various health insurances, including Prior Authorizations
  • Knowledge of medical office systems and procedures, EMR
  • Excellent time management skills and ability to multi-task and prioritize work
  • Friendly, team player, excellent collaborator, and communicator
Preferred:
  • Knowledge of NexTech system
  • Knowledge of Biologics process

Physical Demands: significant amount of sitting, screen time, typing, and assisting patients; lifting up to 25 lbs.; occasional bending and stretching

Work environment: Fast-paced office setting. Working independently, but communicating as needed to patients, providers, coworkers, and supervisor.
 



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