Infusion Authorization Specialist
US-ID-Boise
careers
Req #: 105851
Type: Full-Time
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Overview: At St. Luke's, Infusion Authorization Specialists are a pivotal role that involves extensive interaction with various internal and external stakeholders. These subject matter experts engage with insurance companies, third-party payers, prescription benefit management companies, governmental peer review organizations, and referring physicians' offices. This is a remote position that will require 8-12 weeks training in Boise, Idaho. Shift details: Monday-Friday 8:30am-5pm What you can expect from this role: * obtaining insurance prior authorizations for episode-based infusion treatment referrals primarily administered in SLHS non-oncology infusion centers * providing clear and effective communication to guide providers, patients, and insurance companies through the authorization process. This includes multitasking and communicating via Microsoft Teams, Outlook, and Epic * working proficiently in various insurance portals to submit prior authorizations, perform benefits investigations, and follow up on submission statuses. * other duties as assigned Minimum Qualifications for this Role: * Education: High School Diploma or Equivalent * At least three (3) years of healthcare experience, specifically in one or more of the following areas: authorization, billing, registration, financial advocacy, or home infusion authorizations. * Must live in Idaho, Arizona, Utah or Oregon Preferred qualifications: * EPIC experience * 2 years direct experience with infusion, home infusion authorizations or medical authorizations Responsibilities: The Patient Access Specialist 4 is responsible for responding to patient, provider, and department/service area needs with a high emphasis on customer service and accuracy. This includes, but is not limited to, registration, complex scheduling, referral coordination, benefit verification, preauthorization, order transcription and general inquiries from patients, providers and the general public. This subject matter expert is also responsible to serve as a role model and resource to coworkers. * Supports an exceptional experience through all customer interactions, ensuring professional, timely and accurate communication * both verbally and in writing. * Supports a perspective payment program by communicating organization policies, financial options, explaining insurance coverage/non-coverage. * Utilizes a variety of technology, tools, and resources to support departmental workflows. * Performs one of the following workflows with attention to detail, accuracy and efficiency: * Call front lining * Patient Registration * Complex Scheduling * Referral Coordination * Order Transcription * Pre-Authorization * Benefit Verification * Patient Obligation Estimates * Cross trained to support multiple functional areas. * Serves as a role model, mentor, trainer and/or resource to coworkers. * Serves as subject matter expert and may assume responsibilities during management absence, as requested. * Performs other duties as assigned. Qualifications: * Education: High School Diploma or equivalent. * Experience: 3 years relevant experience. * Licenses/Certifications: None
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