Prior Authorization Coordinator IVIG - Hybrid

Job Description

Job DescriptionDescription:

Job Description

Job Title: Prior Authorization Coordinator

Status: Full Time

Reports To: Biologic Clinical Manager

Location: Training in Main Office in Louisville and then Remote Only

Position Summary:

The Prior Authorization Coordinator IVIG/SCIG/HAE is responsible for demonstrating knowledge and application of job duties within scope of practice and functions under the direction of the manager(s) and/or Director(s); respectfully interacts with all levels of staff; provides assistance, as needed, during assigned duty hours; participates in department activities; promotes independence; adherence to the attendance policy; encourages socialization; advocates for the quality of life of our patients while maintaining compliance with all applicable laws, regulatory and organizational standards; supports the company’s core values.

Summary of Duties and Responsibilities:

• Initiates the intake process and gathers relevant data from the office to complete the referral
• process.
• Verify insurance and eligibility along with obtaining authorizations when necessary.
• Contact patients to confirm information and notify them of the process/status.
• Responsible for obtaining and managing prior authorizations for IVIG/SCIG/HAE medications,
• ensuring patients receive medically necessary treatment while navigating insurance
• requirements.
• Communicates with healthcare providers to gather necessary clinical information and clarify
• treatment plans.
• Assist with medication refill requests for all prescribed medications.
• Any other tasks assigned by management.

Education, Prior Work Experience, Special Skill and Knowledge Requirements:

• High school diploma or equivalent
• Understanding of insurance verification, prior authorization procedures, and billing codes (ICD-
• 10, CPT, HCPCS) is essential.
• At least 2 years of previous IVIG/SCIG/HAE experience including eligibility and authorization.
• Excellent communication, problem-solving, and organizational skills are necessary
• Ability to interact with patients directly and patiently
• Ability to work independently
• Strong computer skills
• EMR experience required
• Must be at least 18 years of age

Physical Demands and Work Environment

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 accommodation may be made to

enable individuals with disabilities to perform the physical demands. The employer retains the right to

change or assign other duties to this position.

1. While performing the duties of this job, the employee is regularly required to prepare, inspect, place,

detect or operate productivity machinery, such as a calculator, copy machine, computer, and computer

printer.

1. The employee is frequently required to remain in a stationary position, move, ascend/descend.
2. Frequently moves boxes weighing up to 30lbs across the office for various needs.
3. Specific vision abilities required by this job include close vision, distance vision, peripheral vision,

depth perception, and the ability to adjust focus.

1. Specific communication abilities required by this job include the ability to communicate and detect,

converse with others, discern, convey, express oneself, and exchange information.

Work Environment

The work environment characteristics described here are representative of those an employee may

encounter while performing the essential functions of this job.

1. The noise level in the work environment is usually moderate; lighting is in the standard range.
2. The employee is subject to infectious waste, potential exposure to allergens in concentrated forms,

diseases, and conditions.

This role operates primarily in an office environment but may require occasional travel for conferences,

meetings, or client interactions.

EEO Compliance:

Family Allergy & Asthma provides equal employment opportunities to all employees and applicants for

employment and prohibits discrimination and harassment of any type without regard to race, color,

religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation,

gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement,

promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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Requirements: