Job Details

Description

Position Summary

The Authorization Coordinator is responsible for maintaining authorizations for all active patients with NuFACTOR. Initiating all re-authorization requests at least 30 days in advance and ensuring all deliveries are properly verified prior to shipping.

Essential Functions and Duties

• Initiates the re-authorization process by gathering relevant data from the physician’s office, and properly submitting re-authorizations to avoid delays in treatment.
• Monitors re-authorizations in NuFACTOR system of record Authorization tracking and works 30 days ahead of expiration date.
• Notifies proper departments of any issues or updates relating to coverage or authorization.
• Annually determines patient’s financial obligation, out of pockets expense and copays.
• Communicates with patients on any benefit changes or changes to their financial obligations.
• Enters all communications and updates in the NuFACTOR system of record notes while working the re-authorizations for active patients.
• Answers telephones utilizing appropriate etiquette and speaks to referral sources, patients, family members, clinicians and payors.
• Complies with all NuFactor policies and procedures and compliance requirements when engaging in activities related to the company.
• Adheres specifically to all company policies and procedures, Federal and State regulations, and laws.
• Display dedication to position responsibilities and achieve assigned goals and objectives.
• Always represent the Company in a professional manner and appearance.
• Understand and internalize the Company’s purpose.
• Display loyalty to the Company and its organizational values.
• Display enthusiasm and dedication to learning how to be more effective on the job and share knowledge with others.
• Work effectively with co-workers, internal and external customers and others by sharing ideas in a constructive and positive manner; listen to and objectively consider ideas and suggestions from others; keep commitments; keep others informed of work progress, timetables, and issues; address problems and issues constructively to find mutually acceptable and practical business solutions; address others by name, title, or other respectful identifier, and; respect the diversity of our work force in actions, words, and deeds.
• Comply with the policies and procedures stated in the Injury and Illness Prevention Program by always working in a safe manner and immediately reporting any injury, safety hazard, or program violation.
• Ensure conduct is consistent with all Compliance Program Policies and procedures when engaging in any activity on behalf of the company. Immediately report any concerns or violations.
• Other duties as assigned.

Qualifications

Education, Knowledge, Skills and Experience

Required Education:

• High School diploma or equivalent required.

Preferred Knowledge:

• One (1) year health care related experience in a pharmacy, home healthcare, infusion related setting or hospital is preferred

Preferred Experience:

• Benefit verification and prior authorizations for specialty medications.

Required Skills:

• Must have strong organizational skills
• Must have a detail orientation and the proven ability to prioritize work
• Must have effective verbal and written communication skills
• Must have the ability to work with limited supervision and as part of a team
• Sound decision-making abilities

Preferred Skills:

• Knowledge of medical and pharmacy terminology and calculations, general pharmacy dispensing requirements, including identification of items requiring prescription and valid prescribing data.
• Excellent verbal and written communication skills and the ability to interact effectively with patients, co-workers and management.
• Ability to work with a high degree of accuracy in an organized, detail oriented manner with appropriate follow-up when required.
• Ability to communicate effectively and at the appropriate level with healthcare professionals and peers.
• Ability to prioritize work and make decisions independently and effectively, often quickly in response to dynamic patient needs, with limited supervision and direction, except where required/restricted by law.
• Working knowledge of state, federal and Joint Commission guidelines/regulations/laws.
• Ability to exercise discretion and maintain confidentiality to the level of required HIPAA standards.
• Ability to use and understand Microsoft Office skills and internet technologies.

Professional Certification:

No

Physical requirements

Vision, hearing, speech, movements requiring the use of wrists, hands and/or fingers. Must have the ability to view a computer screen for long periods and the ability to sit for extended periods. Must have the ability to work the hours and days required to complete the essential functions of the position, as scheduled. Must have the ability to lift and maneuver items of at least 20 lbs. Working condition include normal office setting.

Mental Demands

Learning, thinking, concentration and the ability to work under pressure, particularly during busy times. Must be able to pay close attention to detail and be able to work as a member of a team to ensure excellent customer service. Must have the ability to interact effectively with co-workers and customers, and exercise self-control and diplomacy in customer and employee relations’ situations. Must have the ability to exercise discretion as well as appropriate judgments when necessary. Must be proactive in finding solutions.

Direct Reports

No

EEO/AAP Statement

FFF Enterprises/Nufactor is an equal opportunity employer to all and prohibits discrimination and harassment based on the following characteristics: race, color, caste, religion, religious creed (including religious dress and grooming practices), national origin, ancestry, citizenship, physical or mental disability, medical condition (including cancer and genetic conditions), genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), gender, gender identity, gender expression, age (40 years and over), sexual orientation, veteran or military status, medical leave or other types of protected leave (requesting or approved for leave under the Family and Medical Leave Act or any state protected leaves), domestic violence victim status, political affiliation, reproductive health decision-making, and any other characteristic protected by state or federal anti-discrimination law covering employment. These categories are defined according to Government Code section 12920. The Company prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics.