Biologics & Prior Authorization Coordinator

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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