Infusion Authorization Specialist

6 days ago

Centennial, United States Veros Health Full time
*Benefits*

Pulled from the full job description
* 401(k)
* 401(k) matching
* Dental insurance
* Disability insurance
* Employee assistance program
* Flexible spending account
* Health insurance

*Full job description*

Veros Clinical Services, Infusion and Biologics Center has an exciting opportunity for an experienced Authorization Specialist in Centennial.

Salary Range: $18.29-$23.00

Pay is based on several factors including but not limited to education, work experience, certification, etc. As of the date of this posting, in addition to your salary, Veros offers the following benefits for this position, subject to eligibility requirements: Health, dental, and vision plans; wellness program; health savings account; flexible spending accounts; 401(k) retirement plan; life insurance, short-term disability insurance; long-term disability insurance, Employee Assistance Program; PTO, holiday pay.

*ESSENTIAL DUTIES AND RESPONSIBILITIES*

-Reviews, processes, and audits the medical necessity for each patient regarding the Infusion and/or Biologic treatment and documentation of regimen and pathway adherence (including review of ICD-10 diagnosis codes)

-Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays. Obtains insurance authorization and pre-certification for Infusion and/or Biologic services.

-Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans. Provides prompt feedback to physicians and management regarding pathway documentation issues, and payer issues with non-covered drugs.

-Communicates back to site on insurance update/status within 24 hours of receipt of authorization request; stat requests require same day update on insurance authorization to providers

-Processes insurance/patient correspondence, including denial follow-up. Maintains reimbursement correspondence and filing systems

-Reports any problems, issues, or payer trends.

-Maintains a good working knowledge of Infusion and/or Biologic authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization. Complies with patient confidentiality laws and regulations.

-Work with related assistance programs to ensure patients are setup with necessary coverage and discuss benefits with the patient

-Review and discuss insurance benefits with the patient

-Updates coding/payer guidelines for clinical staff and adheres to NCCN guidelines with obtaining authorization. Tracks pathways and performs various other business office functions on an as needed basis.

*POSITION REQUIREMENTS*

High school degree or equivalent. Minimum two (2) years medical insurance verification and authorization required. Billing and coding experience preferred.

All qualified candidates are required to pass a background check and non-federal drug test (which excludes marijuana) post offer of employment and prior to hire.

*PHYSICAL DEMANDS*

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.

All qualified candidates are required to pass a background check and non-federal drug test (which excludes marijuana) post offer of employment and prior to hire.

Job Type: Full-time

Pay: $18.29 - $23.00 per hour

Benefits:
* 401(k) matching
* Dental insurance
* Employee assistance program
* Health insurance
* Life insurance
* Paid time off
* Tuition reimbursement
* Vision insurance

Weekly day range:
* Monday to Friday

Education:
* High school or equivalent (Required)

Experience:
* Insurance verification: 1 year (Required)

Work Location: In person

Job Type: Full-time

Pay: $19.00 - $23.00 per hour

Expected hours: 40.0 per week

Experience:
* Insurance verification: 1 year (Preferred)
* Medical billing: 1 year (Preferred)

Work Location: In person

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