The Infusion Coordinator ensures our patients receive timely access to infusion therapies by coordinating and managing complex insurance prior authorizations. The Infusion Coordinator will navigate specialty medication prior authorizations, possess exceptional organizational skills, and thrive in a fast-paced, collaborative environment. This individual will work closely with providers, patients, insurance carriers, and our prior authorization vendor to ensure accurate, efficient, and timely processing of infusion authorizations.
Key Responsibilities
- Review and oversee infusion prior authorization submissions completed through our prior authorization platform (ForUs) to ensure accuracy and completeness.
- Coordinate the prior authorization process for infusion medications, including obtaining approvals, monitoring pending requests, and resolving delays.
- Respond to prior authorization denials by gathering and submitting additional clinical documentation, letters of medical necessity, appeals, and other supporting information.
- Communicate effectively with providers, clinical staff, patients, insurance companies, specialty pharmacies, and infusion vendors regarding authorization status and required documentation.
- Maintain accurate, thorough, and timely documentation within the electronic medical record (EMR).
- Monitor multiple patient authorization requests simultaneously while ensuring deadlines are met and patient care is not delayed.
- Collaborate with physicians, advanced practice providers, nursing staff, and the infusion team to facilitate timely treatment.
- Verify insurance benefits and identify payer-specific authorization requirements.
- Track authorization expiration dates and coordinate reauthorizations as needed.
- Maintain a strong understanding of payer policies, specialty medications, and evolving authorization requirements.
- Participate in department process improvement initiatives and maintain compliance with HIPAA and organizational policies.
- Maintain strict patient confidentiality and professionalism.
- Other duties as assigned. This job description is not designed to cover or contain a comprehensive list of activities, duties, or responsibilities that are required of the employee. They may change, or new ones may be assigned at any time with or without notice.
Qualifications
- High school diploma or equivalent.
- Minimum of 2–3 years of prior authorization experience in a healthcare setting.
- Experience working with commercial insurance, Medicare, and Medicaid prior authorization processes.
- Strong attention to detail with excellent organizational and time management skills.
- Ability to manage multiple priorities in a fast-paced environment.
- Excellent written and verbal communication skills.
- Proficiency with electronic medical records and Microsoft Office applications.
- Ability to work independently in a remote environment while collaborating effectively with the team.
- Strong attention to detail and problem-solving abilities.
- Ability to prioritize tasks and manage time effectively.
- Experience with specialty medication prior authorizations within rheumatology, oncology, gastroenterology, neurology, or another specialty practice preferred.
Benefits
- 100% employer-paid medical insurance for employees
- 401(k) with company match and employer-funded profit sharing
- Four-day work week (Monday – Thursday), supporting strong work/life balance
- Paid holidays and Paid Time Off (PTO)
- A collaborative, team-oriented culture with strong support and a shared commitment to exceptional patient care
Equal Employment Opportunity
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Experience:
- prior authorization: 2 years (Preferred)
- infusion prior authorization: 1 year (Preferred)
Location:
Work Location: Remote
