[Hiring] Referral and Authorization Coordinator @UnityPoint Health

Role Description

The Referral and Authorization Coordinator – Infusion Services is responsible for managing new referrals and coordinating authorization processes to ensure timely, accurate, and compliant access to infusion therapies across UnityPoint Health’s ambulatory infusion enterprise. This role enters and maintains referral information in the electronic medical record (EMR), evaluates medical necessity, coordinates prior authorizations, and collaborates with providers and payers to prevent treatment delays for high-cost, complex infusion medications.

• Manage infusion service referrals, including accurate intake, scheduling, medication coordination, and timely communication with patients and referring providers.
• Conduct insurance eligibility and benefit investigations, including formulary reviews, coverage restrictions, network requirements, and patient cost-share assessments.
• Submit and monitor prior authorizations, obtain required clinical documentation, and follow up with payers to support timely approval of infusion therapies.
• Review authorization denials, coordinate appeals, and collaborate with providers to identify appropriate alternative therapies when necessary.
• Coordinate with medication assistance advocates to connect patients with manufacturer assistance programs, foundations, and other financial resources to reduce barriers to treatment.
• Maintain positive relationships with patients, providers, referral sources, pharmacies, and internal teams while directing inquiries to the appropriate service line.
• Provide excellent customer service, maintain accurate documentation, meet productivity and performance expectations, and support process improvements and other operational needs as assigned.

Qualifications

• High School Diploma/GED High school graduate or equivalent. Required
• Pharmacy technician certification or registration in the state(s) of practice, as applicable (Iowa, Illinois, and/or Wisconsin). Preferred

Requirements

• 2 years Experience with benefit investigations, formulary reviews, and prior authorization workflows. Preferred
• 2 years Experience in infusion services, specialty pharmacy, or high-cost medication workflows. Preferred
• 2 years Experience using electronic medical records (EMRs) and payer portals. Preferred
• 1 year Medical experience, preferably in community health, home health, or pharmacy. Required

Benefits

• Paid time off, parental leave, 401K matching, and an employee recognition program.
• Dental and health insurance, paid holidays, short and long-term disability, and more.
• Pet insurance for your four-legged family members.
• Early access to earned wages with Daily Pay.
• Tuition reimbursement to help further your career.
• Adoption assistance to help you grow your family.