Infusion Biologics Coordinator

Summary: Under the direction of the Manager of Infusion, the Infusion coordinator will engage in acting as the liaison between patients, clinical staff, insurance companies and manufacturer companies by performing benefits investigations, obtain authorizations, enroll in copay assistance, review scheduling, assist in reviewing patients’ claims that have been submitted to third party payors but have not been fully adjudicated and/or denied. Responsibilities include clear communication and supports patient education regarding biologic therapies, and maximizing reimbursement through programs that provide funding or provision of infusion medications. Essential Responsibilities: Perform all necessary tasks to verify medical benefits, insurance eligibility and whether referrals are required by the patient’s insurance carrier. Ensure that all necessary prior authorizations are obtained before a patient arrives for a scheduled procedure. Collaborate with healthcare providers to verify treatment plans, obtain necessary authorizations, and ensure compliance with clinical protocols. Communicate with patient, staff, administrators, and operations management in a timely manner. Perform other duties as required Essential Skills: Must be extremely detail oriented. Must be able to read and comprehend specific insurance policies and protocols put forth by various insurance carriers to ensure compliance. Basic understanding of CPT and ICD coding. Basic understanding of rudimentary medical terminology. Excellent judgement and decision making. Problem solving and organizational skills. Reliability, Accuracy and Efficiency when dealing with patients or third-party payors. Excellent verbal and written communication skills. Ability to use good judgments in highly emotional and demanding situations. Ability to react to frequent changes in duties and volume of work. Excellent oral and written communication skills. Ability to manage multiple tasks with ease and efficiency. Effective interpersonal skills, including the ability to promote teamwork. Strong problem-solving skills. Maintains confidentiality of sensitive information Education and Experience Required: Knowledge of third-party insurance authorization and billing practices Knowledge of internal billing structure, and billing procedures Experience with patient assistance programs High-school diploma or GED. Associates degree or higher in health sciences or related field preferred. 2 years’ experience in a large medical practice, specialty pharmacy, outpatient infusion center or hospital performing similar tasks, preferably in infusion therapy or biologics coordination. Proficiency in electronic medical records (EMR) system and scheduling software. Proficiency with Microsoft office products including Word and Excel. Days/Hours This is a full-time hybrid position, and hours of work and days are Monday through Friday, at a fixed schedule determined by the needs of ADH. We offer competitive pay, generous benefits, including Medical, Dental, Vision, Life Insurance, Voluntary, Time-Off Benefits, EAP, 401K and Commuter Benefits. This is a full-time hybrid position, and hours of work and days are Monday through Friday during the day