Pharmacy Infusion Care Prior Auth Specialist, System Infusion Pharmacy, FT 8:30A-5P

6 days ago

Miami Lakes FL United States Baptist Health South Florida Full time
Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. Baptist Health is supported by philanthropy and committed to its faith-based charitable mission of medical excellence.

Our mission, vision, and values make us who we are at Baptist Health and are at the center of everything we do. At Baptist Health, we positively impact the human experience for patients, employees, and physicians. Our success comes from a culture of quality and dedication that is instilled into every member of the Baptist Health family.

This year, and for 24 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, based on employee feedback. We’ve also been recognized as one of America’s Most Innovative Companies and People Magazine included us in 50 Companies That Care. Based on the U.S. News & World Report 2023-2024 Best Hospital Rankings, Baptist Health is the most awarded healthcare system in South Florida, with its hospitals and institutes earning 45 high-performing honors.

But really, the reason we’re excited to come to work is the people.

Working together, we form personal connections with our colleagues that are stronger than most of us have experienced at other jobs. We develop caring relationships with our patients and their families that go beyond just delivering healthcare. After all, we know what it’s like to be in their shoes. Many of us have been patients here and have had family members as patients here. We’re committed to delivering quality care in the most compassionate way possible because we feel a personal stake in the outcomes. When it comes to caring for people, we’re all in.

Description:

Obtain prior authorization from payors. Route patient referrals to the appropriate department or individual(s). Establish and maintain accurate and complete patient records. Receive calls from new patients and referral sources and document all customer communications. Maintain a broad knowledge base concerning insurances, payor policies, and prescription medication in order to assist with the verification of insurance coverage for patients by obtaining all necessary information. Identifies patients who require authorization for all infusion services. Coordinates intake and authorizations for multiple sites as assigned. Identifies patients who require authorization for all infusion services. Coordinates intake and authorizations for multiple sites as assigned.
Qualifications:

Degrees:
Associates.
Additional Qualifications:
Health Related Field, MA, or Registered Pharmacy Technician preferred.
The Infusion Care Prior Authorization Specialist role requires critical thinking skills, effective communication, decisive judgement, and the ability to work with minimal supervision.
The incumbent must be able to work in a fast-paced environment.
The role requires payor medication authorization experience, as well as an understanding and knowledge of payer‘s requirements and expectations.
Responsible for obtaining, coordinating, and processing information about new patients in a timely manner.
Must have proficient computer skills including, EMR and electronic medical management system, outlook, and MS word, Cerner/Soarian experience preferred.
Education and training in medical terminology preferred.
Minimum Required Experience:

EOE, including disability/vets

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