Patient Access Coordinator- Prior Authorizations
- New Orleans, LA, USA
Here at CiNQ Recruitment, we believe in finding the right fit, for you and our clients. Whether you seek long-term employment solutions for your business or your next career move, we understand the importance of individual and business needs. With over 30 years of successful staffing and recruiting experience, we excel at providing passive candidates with the right skills and cultural fit for specialized positions. Here is the opportunity to work with an exciting pharmaceutical company.
Perform duties to investigate, verify and track patient insurance eligibility for medication services; initiate and obtain authorization or reauthorization for services, working within the limits of standard or accepted practice.
- Call patients and/or clinics to obtain patient’s clinical information in order to fill out prior authorization forms on behalf of patients
- Verify monthly eligibility for existing patients and conduct new benefits investigation if insurance changes.
- Obtain clinical, lab, and medical testing documentation from physicians’ offices for submission of prior authorization. Track prior authorizations and reauthorizations through the process until approved.
- Communicate with patients, physicians, and other departments on benefits and the status of authorization and reauthorization requests. Communicate denials to physicians’ offices and provide follow-up details on the peer to peer or appeal options.
- Regularly communicate the status of the intake process to other departments, including nursing, pharmacy, and sales.
- Identify in-network or mandated pharmacy providers if unable to service a patient due to insurance constraints. Communicate related information to the patient and the physician offices and triage referral as directed.
- Communicate clinical inquiries to pharmacy or nursing team and arrange for direct patient communication or provide responses to patients, as appropriate. Identify opportunities for counseling by Registered Pharmacists or Nurse Counselors and make referrals as appropriate.
- Build and maintain effective business relationships with prescribers treating assigned set of disease states, and provide ongoing communication of specific case-related information as appropriate.
Pay Rate: Starting at $14.50/HR+
- Basic High School and additional specialized training in gaining prior authorizations from insurance companies for specific drugs
- Minimum 3 years’ experience in healthcare customer service with knowledge of benefits access processes.
- Strong attention to detail and someone able to multitask.
All your information will be kept confidential according to EEO guidelines.