[Hiring] Prior Authorization Coordinator @IVX Health

Role Description

Join IVX Health as a Prior Authorization Coordinator! Join a team that’s redefining infusion care and creating exceptional patient experiences. Are you experienced in navigating the complexities of prior authorizations for biologics or oncology therapies? IVX Health is looking for a driven and detail-oriented Prior Authorization Coordinator to support our rapidly growing team. In this role, you’ll have the opportunity to make a meaningful impact by facilitating the approval process for life-changing specialty treatments.

Location and Schedule at a Glance:

• Work Options: Fully Remote, Hybrid, or In-office (Brentwood, TN)
• Schedule: Monday - Friday, standard business hours (no nights, weekends, or holidays)

What You Will Do:

• Review and Process Prior Authorizations: Thoroughly review Prior Authorization orders and ensure timely and accurate completion.
• Manage Clinical Documentation: Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions.
• Submit and Track Prior Authorizations: Follow criteria for medication approvals and accurately submit requests to insurance providers.
• Resolve Authorization Issues: Investigate and resolve outstanding medical documentation concerns and assist in resolving denied claims.
• Support Patients and Providers: Communicate effectively with patients, clinical staff, and insurance representatives regarding the Prior Authorization process.
• Ensure Compliance and Process Improvement: Stay up to date with evolving payer policies and identify ways to enhance workflow efficiency.
• Perform Additional Duties: Take on other responsibilities as assigned to support patient care and operational objectives.

Qualifications

• Prior Authorization Expertise is Essential: Hands-on experience with prior authorizations for biologics, oncology, or specialty therapies, along with a strong understanding of payer guidelines.
• Exceptional Communication Skills: Frequent interaction with clinical teams, insurance companies, and patients; must communicate clearly and professionally.
• Self-Motivated and Accountable: Expected to be present, engaged, and consistently perform at a high level without direct supervision.
• Tech-Savvy and Detail-Oriented: Proficiency in Electronic Health Records (EHR) systems, payer portals, and Microsoft Office Suite is required.
• High School Diploma or GED required.
• Associate’s degree in Medical Office Management, Medical Insurance, or Medical Coding is a plus.
• Minimum of three (3) years of experience in hospital or clinical service access, physician office scheduling, or a similar role.
• Certified Medical Assistant (CMA) is a plus.
• Experience with prior authorizations for biologics, oncology, or specialty therapies preferred.

Benefits

• Make a Meaningful Impact: Play a critical role in securing approvals for life-changing specialty treatments.
• Grow Your Career: Clear career path for Prior Authorization Coordinators, with opportunities for promotion based on performance and expertise.
• Be Part of a Supportive and High-Performing Team: Work alongside a motivated, goal-driven team.
• Support and Development: Access to continuing education, professional development resources, and mentorship opportunities.
• Work-Life Balance: Flexible work options, paid time off, and a no nights, no weekends schedule.
• Pay based on factors such as market location, job-related knowledge, skills, and experience.
• Prior Authorization Coordinator Pay Range: $22 - $24 USD.