Job Details
Qualifications
- Associate's degree
- Certified Medical Assistant
- Customer service
- High school diploma or GED
- Insurance verification
- Medical coding
- Microsoft Office
Benefits
- AD&D insurance
- Dental insurance
- Flexible schedule
- Health insurance
- Health savings account
Job Description
Join us at IVX Health and help make an impact our patients lives from the start of their patient journey! We are seeking a Prior Authorization Coordinator I to support our continued growth! Our HQ is based right outside of Nashville in Brentwood, TN. We are seeking candidates nationwide with the option to work in-office, hybrid, or fully-remote!
ABOUT US
IVX Health is a national provider of infusion and injection therapy for those with Rheumatoid Arthritis, Crohn's Disease, Multiple Sclerosis and other complex chronic conditions. IVX offers a different, better approach to caring for our patients and believes it is vital to take the same approach with our employees. We strive to empower our team to succeed while embodying our core values: Be Kind, Do What's Right, Never Settle, Make It Happen, and Enjoy the Ride.
ABOUT THE ROLE
Our Prior Authorization Coordinators form the core of our Revenue Cycle team. Reporting to the Manager of Prior Authorization, the Prior Authorization (PA) Coordinator I works collaboratively and interfaces directly with IVX Health clinical staff, payer representatives, and patients daily to review scheduled services and to ensure complete and accurate information is documented. This role completes necessary clinical review for prior authorizations as required by governmental and commercial payers, satisfying maximum net revenues and minimum avoidable losses for authorizations. The ability to multi-task in multiple business office / practice management systems and offer exceptional customer service is the foundation of this role.
RESPONSIBILITIES
- Review and process all assigned Prior Authorization orders to completion
- Obtain clinical information (including but not limited to medical history, diagnosis, and any relevant lab reports) necessary to complete the Prior Authorization
- Diligently reviews the clinical information for completeness for insurance requirements and follows up with any questions
- Follow the Prior Authorization Criteria for medications and submits requests
- Communicate with insurance companies to pre-certify/authorize medications
- Investigate outstanding medical documentation to ensure a patients account is not suspended
- Assist with any denied claims to resolve potential mistakes by providing clinical information
- Assist with medication change process by providing clinical information
- Clearly support patient experience through patient-centered communications demonstrating excellent customer service skills
- Assist with payer directed patients from receipt through scheduling while actively communicating with all stakeholders.
- Perform duties and job functions in accordance with the policies and procedures established for the department
- Recommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and services performed
- Actively participate in problem identification and coordinates resolution between appropriate parties
BENEFITS + PERKS
- Flexible work schedule that promotes a positive work-life balance
- 401(k) program with company-match
- Comprehensive Health, Dental, and Vision Insurance plans
- Company-Paid Life/AD&D Insurance
- Voluntary Accident, Critical Illness, and Hospital Indemnity Insurance
- Voluntary Short-Term and Long-Term Disability Insurance
- Tuition Reimbursement Program
- Charitable Giving Match and Community Involvement PTO Program
- Employee Referral Bonus Program
ESSENTIAL COMPETENCIES
- Knowledge of current authorization regulatory guidelines and requirements
- Excellent organizational, consultative, analytical and problem-solving skills
- Ability to work independently under general supervision and effectively prioritize workload
- Ability to multitask and adapt to fast-paced work environment
- Strong interpersonal skills
- Ability to collaborate and communicate at all levels of an organization
- Knowledge of basic medical terminology
- Proficiency with standard office software applications (Outlook, Microsoft Office, Teams®)
EDUCATION + EXPERIENCE
- High School Diploma or GED required
- 2 Year / Associates Degree in Medical Office Managing, Medical Insurance, or Medical Coding strongly preferred
- Three years experience working in hospital or clinical service access, physician office scheduling, or similar role
- Certified Medical Assistant is a plus!
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PAY RANGE*
Pay is based on a number of factors including market location, job-related knowledge, skills, and experience and is benchmarked against similar organizations to our size and industry. For our Prior Authorization Coordinator role, we generally pay new hires between 20.00 and 24.00 per hour. It is not typical for an individual to be hired at or near the top of the range for roles and compensation decisions are dependent on the facts and circumstances of each situation. In addition to cash pay, full-time regular positions are eligible for 401(k), health benefits, and other company benefits; some of these benefits may also be available for part-time positions.
EEO STATEMENT
IVX Health is an equal opportunity employer and prohibits discrimination and harassment of any kind. IVX Health makes employment decisions on the basis of business needs, job requirements, individual qualifications and merit. IVX Health wants to have the best available people in every job. Therefore, IVX Health does not permit its employees to harass, discriminate or retaliate against other employees or applicants because of race, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, military and veteran status, age, physical or mental disability, genetic characteristic, reproductive health decisions, family or parental status or any other consideration made unlawful by applicable laws. Equal employment opportunity will be extended to all persons in all aspects of the employer-employee relationship. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation benefits, and separation of employment.
Job Type: Full-time
Pay: $20.00 - $24.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Health savings account
- Paid time off
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work Location: Remote