Infusion Clinical Authorization Specialist

3 weeks ago

Lawrence MA United States Lawrence General Hospital Full time

Under the direction of the Infusion Operations Manager and Director of Integrated Care, the Infusion Clinical Authorization Specialist is responsible for ensuring all information for proper financial reimbursement is validated prior to the date of service and if necessary submission of clinical documentation for authorizations of various high-cost pharmaceuticals. # The Infusion Clinical Authorization Specialist collaborates with insurance companies to proactively validate benefits, eligibility, and authorization/referral requirements. # Communicates with patients to ensure they understand their payment obligations and proactively attempts to collect payment while ensuring a positive patient experience. EDUCATION AND RELATED EXPERIENCE: Required: ### #High School Diploma or equivalent ### #Minimum of 2 year of clinical and/or related experience ### #Well organized and able to multi-task quickly and effectively.# ### #Works well in high-pressure situations.# ### #Ability to work closely and effectively with peers across the organization and with the medical staff. ### #Motivated, shows initiative, and collaborates well in a team setting. ### #Ability to be flexible and meet the needs of a growing department. ### #Shows strong analytical and problem-solving skills. ### #Superior written and verbal communication skills# ### #Strong understanding and ability to work in various computing/information systems and Microsoft Office product suite. Preferred: ### #Bachelor#s degree ### #Case Management, Utilization Review or Prior Authorization experience# ### #Bilingual English/Spanish ### #Knowledge of third-party payer rules and regulations# ### #Revenue Cycle experience Lawrence General Hospital is a private, non-profit community hospital providing the Merrimack Valley # southern New Hampshire regions with patient-centered, compassionate, and quality health care for the whole family. For over 140 years, the dedicated doctors, nurses, and staff of Lawrence General have been committed to improving the health of the people and communities we serve. We are an Equal Opportunity Employer committed to hiring a diverse workforce.

Under the direction of the Infusion Operations Manager and Director of Integrated Care, the Infusion Clinical Authorization Specialist is responsible for ensuring all information for proper financial reimbursement is validated prior to the date of service and if necessary submission of clinical documentation for authorizations of various high-cost pharmaceuticals. The Infusion Clinical Authorization Specialist collaborates with insurance companies to proactively validate benefits, eligibility, and authorization/referral requirements. Communicates with patients to ensure they understand their payment obligations and proactively attempts to collect payment while ensuring a positive patient experience.

EDUCATION AND RELATED EXPERIENCE:

Required:

* High School Diploma or equivalent
* Minimum of 2 year of clinical and/or related experience
* Well organized and able to multi-task quickly and effectively.
* Works well in high-pressure situations.
* Ability to work closely and effectively with peers across the organization and with the medical staff.
* Motivated, shows initiative, and collaborates well in a team setting.
* Ability to be flexible and meet the needs of a growing department.
* Shows strong analytical and problem-solving skills.
* Superior written and verbal communication skills
* Strong understanding and ability to work in various computing/information systems and Microsoft Office product suite.

Preferred:

* Bachelor's degree
* Case Management, Utilization Review or Prior Authorization experience
* Bilingual English/Spanish
* Knowledge of third-party payer rules and regulations
* Revenue Cycle experience

Lawrence General Hospital is a private, non-profit community hospital providing the Merrimack Valley & southern New Hampshire regions with patient-centered, compassionate, and quality health care for the whole family. For over 140 years, the dedicated doctors, nurses, and staff of Lawrence General have been committed to improving the health of the people and communities we serve.

We are an Equal Opportunity Employer committed to hiring a diverse workforce.

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