Competitive wages with annual merit-based increases
Flexible schedules with no weekends or holidays
Comprehensive benefits including affordable medical, dental, and vision insurance plans
401(k) with a match and referral bonus opportunities
Paid time off and an education assistance program
Work remotely from anywhere in the U.S. within specified hours
What to Expect (Job Responsibilities):
Conduct prior authorization reviews to determine medical necessity based on clinical expertise
Review patient documentation including progress notes, lab reports, and treatment plans to meet payer criteria
Request additional clinical information as necessary and assist in creating clinical support packets for appeals
Document and construct clinical cases for appeal submissions in instances of authorization denials
Provide training and support across departments to enhance understanding of specialty drugs and prior authorization processes
What is Required (Qualifications):
Bachelor’s degree in a healthcare field or 3 years of relevant experience
Experience in denial support, clinical reviews, and appeals for infusion services
Excellent communication and interpersonal skills
Proficiency in Microsoft Word, Excel, and PowerPoint
Ability to manage stress and effectively meet program objectives
How to Stand Out (Preferred Qualifications):
Experience with patients requiring specialty infusion services
Strong customer service skills and a flexible communication style
Ability to work as a motivated team player with excellent listening abilities
Self-starter attitude with a results-oriented approach
Familiarity with payer medical policies and resources
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