Top 76 Enrollment and eligibility representative Jobs in Plano, Tx

Specialty Pharmacy Intake & Authorization Coordinator
Basic Home Infusion —Farmers Branch, TX
- $65,000 - $75,000 a year
- Full-time
- Hybrid work
- Background check
- Mid-level
- Office
Quick Apply
6d
Subgerente de tienda bilingüe
Community Choice Financial Family of Brands —Frisco, TX
- $16 an hour
- Weekends as needed
- Background check
- 18 years or older
- Spanish
- Paid training
- Health savings account
12d
Physical Therapist
Centre For Neuro Skills —Irving, TX
- Full-time
- Physical & Rehabilitation Medicine
- Mid-level
- Master's degree
- Paid holidays
- Health insurance
Assistant Store Manager (Bilingual)
Community Choice Financial Family of Brands —Dallas, TX
- $16 an hour
- Weekends as needed
- Background check
- 18 years or older
- Spanish
- Paid training
- Health savings account
4d
Retail Sales Associate - 0025
First Cash, Inc. —Dallas, TX
- $10 - $14 an hour
- 8 hour shift
- Bilingual
- 18 years or older
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
Customer Service Representative (Bilingual)
Community Choice Financial Family of Brands —Lewisville, TX
- $15 an hour
- Weekends as needed
- Background check
- 18 years or older
- Spanish
- Paid training
- Health savings account
5d
Retail Sales Associate - 0066
First Cash, Inc. —Garland, TX
- $10 - $14 an hour
- 8 hour shift
- Bilingual
- 18 years or older
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
Retail Sales Associate - 0346
First Cash, Inc. —Garland, TX
- $10 - $14 an hour
- 8 hour shift
- Bilingual
- 18 years or older
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
Customer Service Representative (Bilingual)
Community Choice Financial Family of Brands —Balch Springs, TX
- $15 an hour
- Weekends as needed
- Background check
- 18 years or older
- Spanish
- Paid training
- Health savings account
Retail Assistant Store Manager - 2111
First Cash, Inc. —Lewisville, TX
- $13.00 - $17.50 an hour
- 8 hour shift
- Bilingual
- 18 years or older
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
Retail Assistant Store Manager - 2160
First Cash, Inc. —Irving, TX
- $13 - $19 an hour
- 8 hour shift
- Bilingual
- 18 years or older
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
6d
Retail Assistant Store Manager - 2150
First Cash, Inc. —Dallas, TX
- $13 - $19 an hour
- 8 hour shift
- Bilingual
- 18 years or older
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
14d
Retail Sales Associate - 0059
First Cash, Inc. —Dallas, TX
- $10 - $14 an hour
- 8 hour shift
- Bilingual
- 18 years or older
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
Admissions Representative
Milan Institute —Plano, TX
- Mid-level
- High school diploma or GED
- University
- Paid holidays
- Health insurance
Quick Apply
Mane Desk Representative (HR Title: Enrollment Resources Representative)
Southern Methodist University —Dallas, TX
- $24.11 an hour
- Extended hours
- Spanish
- Microsoft Outlook
- Data analysis skills
- Health insurance
- Dental insurance
Business Analyst
Brown & Brown —Plano, TX
- Full-time
- Mid-level
- Office
- 3 years
- Employee stock purchase plan
- Paid holidays
11d
Enrollment Manager
Uplift Education —Dallas, TX
- $65,000 a year
- Online Application
- Spanish
- Bachelor of Science
- Mid-level
- Mileage reimbursement
Healthcare Customer Care Representative
Careington International Corporation —Frisco, TX
- From $18.25 an hour
- Full-time
- Background check
- Spanish
- Microsoft Excel
- Paid holidays
- Paid time off
Quick Apply
13d
Billing and Credentialing Specialist
Madea Home Care Services —Dallas, TX
- $23 - $25 an hour
- Full-time
- Nursing
- Pass drug screening
- HIPAA
Quick Apply
6d
SQL Server Database Administrator
Brown & Brown —Plano, TX
- Full-time
- Computer science
- Computer Science
- DevOps
- Employee stock purchase plan
- Paid holidays

I want to receive the latest job alert for enrollment and eligibility representative in plano, tx

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

enrollment and eligibility representative jobs near plano, tx

Retail Sales Associate jobs in Garland, TX

Physical Therapist jobs in Irving, TX

Credentialing Specialist jobs in Dallas, TX

Customer Support Representative jobs in Frisco, TX

Human Resources Representative jobs in Dallas, TX

Business Analyst jobs in Plano, TX

Database Administrator jobs in Plano, TX

Customer Service Representative jobs in Lewisville, TX

Retail Assistant Store Manager jobs in Dallas, TX

Assistant Store Manager jobs in Dallas, TX

Retail Sales Associate jobs in Dallas, TX

Retail jobs in Dallas, TX

Retail Sales Associate jobs in Las Vegas, NV

Retail Sales Associate jobs in Daly City, CA

Patient Care Associate Mercy jobs in St. Louis, MO

Retail Sales Associate jobs in Rockwall, TX

Retail jobs in Stockbridge, GA

Retail Sales Associate jobs in Taunton, MA

Wealth Management Associate jobs in Washington, DC

Admission Representative jobs in Sacramento, CA

Specialty Pharmacy Intake & Authorization Coordinator

Basic Home Infusion -
Farmers Branch, TX

Quick Apply

Job Details

Full-time
$65,000 - $75,000 a year
6 days ago

Qualifications

Pharmacy Information Systems (PIS)
Overseeing health insurance pre-certification
Medicare
Interpersonal skills
Managed care organization experience
High school diploma or GED
Medicaid health insurance
Records management
Clinical information systems
Organizational skills
Medicaid
Productivity software
Manual handling
Healthcare reimbursement methods

Full Job Description

Specialty Pharmacy Intake & Authorization Coordinator

Basic Home Infusion (BHI) supports physicians in managing their TDD patients—and your entire practice.

Today’s targeted drug delivery (TDD) and infusion therapies demand seamless coordination between physicians, care teams, and patients. BHI brings all three together—empowering doctors to extend care beyond the clinic, enabling staff to streamline and centralize management, and ensuring patients receive TDD in the comfort of their homes from experienced nurses.

BHI connects physicians, provider staff, and patients to deliver better home infusion.

Position Summary
We are currently hiring for a Specialty Pharmacy Intake & Authorization Coordinator who will be responsible for managing the referral, intake, insurance verification, and authorization processes for patients prescribed immunoglobulin therapies (IVIG and SCIG) and other specialty medications. This role serves as a critical liaison between prescribers, patients, payers, pharmacists, nursing teams, and manufacturer support programs to ensure timely access to therapy. This is a hybrid role with 3 days in office.

The coordinator is responsible for gathering clinical documentation, submitting and tracking prior authorizations, coordinating financial assistance resources, and facilitating a seamless patient onboarding experience. The ideal candidate possesses strong knowledge of specialty pharmacy reimbursement processes, payer requirements, and immunoglobulin therapies.

Essential Duties and Responsibilities

Intake & Referral Management

Receive, review, and process referrals for IG and other specialty medication therapies.
Validate referral completeness, including prescriptions, clinical documentation, insurance information, and patient demographics.
Enter referral information into pharmacy management and reimbursement systems.
Prioritize referrals based on payer requirements, therapy urgency, and start-of-care timelines.
Communicate with provider offices to obtain missing documentation and clarify referral details.

Benefits Investigation

Conduct comprehensive insurance benefit verification for commercial, Medicare, Medicaid, and managed care plans.
Determine patient eligibility, coverage requirements, and authorization needs.
Verify preferred products, site-of-care restrictions, infusion requirements, and network participation.
Accurately communicate patient financial responsibility and coverage information to internal stakeholders.

Prior Authorization & Appeals

Prepare and submit prior authorization requests for immunoglobulin therapies.
Gather and review supporting clinical documentation, including diagnosis information, laboratory results, treatment history, and medical necessity documentation.
Monitor authorization status and proactively follow up with insurance carriers.
Coordinate peer-to-peer review requests and additional payer requirements.
Assist with denial management, reconsiderations, and appeals processes.
Maintain detailed records of authorization activities and outcomes.

Financial Assistance Coordination

Identify patients who may benefit from manufacturer copay assistance or patient assistance programs.
Facilitate enrollment into available financial assistance programs.
Educate patients regarding available support resources and financial obligations.
Track program enrollment and renewal requirements.

Patient & Provider Communication

Serve as a primary point of contact during the onboarding process.
Provide timely updates to patients, providers, account managers, pharmacists, and clinical teams.
Educate patients regarding intake requirements, authorization status, and therapy initiation timelines.
Maintain professional relationships with physician offices, hospitals, clinics, and manufacturer support programs.

Therapy Access Coordination

Collaborate with pharmacists, nursing teams, and scheduling departments to expedite therapy initiation.
Coordinate site-of-care requirements and payer-mandated treatment settings.
Facilitate transitions between home infusion, infusion suite, or alternate care settings as required.
Ensure all authorization requirements are met before scheduling services or dispensing therapy.

Compliance & Documentation

Maintain accurate, complete, and timely documentation in accordance with company policies.
Ensure compliance with HIPAA, state and federal regulations, and accreditation standards.
Participate in quality assurance, audit preparation, and accreditation activities.
Maintain confidentiality of patient and healthcare information.

Required Qualifications

High school diploma or equivalent required.
Experience with medical and pharmacy benefit investigations.
Knowledge of commercial, Medicare, and Medicaid insurance processes.
Strong understanding of prior authorization workflows.
Excellent verbal and written communication skills.
Strong organizational skills and ability to manage multiple referrals simultaneously.
Proficiency with pharmacy software, EMR systems, and Microsoft Office applications.

Preferred Qualifications

Minimum 2 years of healthcare reimbursement, specialty pharmacy, infusion, or prior authorization experience.
Experience supporting IG and specialty medication therapies.
Home infusion or specialty infusion experience.
Knowledge of immunology, neurology, rheumatology, hematology, or rare disease therapies.
Familiarity with specialty pharmacy accreditation standards.
Experience with appeals, denials management, and payer escalation processes.
Understanding of specialty drug reimbursement and site-of-care optimization strategies.

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 accommodations may be made to enable individuals with disabilities to perform the essential functions.

The employee may be frequently required to stand, sit, walk, see, hear; use hands and fingers regularly, handle, or feel objects, tools, or controls, reach with hands and arms, bend at the knees and waist - such as to access equipment.
The employee may frequently lift and/or move, push and pull equipment, up to 5 pounds and may occasionally lift and/or move up to 15 pounds.

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned.

At Basic Home Infusion, we are deeply committed to promoting diversity, equity, and inclusion in our provision of intrathecal infusion pain management services. We recognize that these core values are essential for achieving optimal patient outcomes and creating a supportive and inclusive environment for our team members.

Pay: $65,000.00 - $75,000.00 per year

Work Location: Hybrid remote in Farmers Branch, TX 75229

Quick Apply

Refine Your Search

enrollment and eligibility representative jobs in plano, tx

Specialty Pharmacy Intake & Authorization Coordinator

Subgerente de tienda bilingüe

Physical Therapist

Assistant Store Manager (Bilingual)

Retail Sales Associate - 0025

Customer Service Representative (Bilingual)

Retail Sales Associate - 0066

Retail Sales Associate - 0346

Customer Service Representative (Bilingual)

Retail Assistant Store Manager - 2111

Retail Assistant Store Manager - 2160

Retail Assistant Store Manager - 2150

Retail Sales Associate - 0059

Admissions Representative

Mane Desk Representative (HR Title: Enrollment Resources Representative)

Business Analyst

Enrollment Manager

Healthcare Customer Care Representative

Billing and Credentialing Specialist

SQL Server Database Administrator

I want to receive the latest job alert for enrollment and eligibility representative in plano, tx

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected