Biologics & Prior Authorization Coordinator

Ocala
Full Time
Entry Level
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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