Documentation Authorization Specialist

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details :

Responsible for issuing initial authorization and renewal authorizations to nursing agencies for skilled infusion visits. Responsible for the generation and follow up of needed billing documentation.

Responsibilities

Issuing of initial and renewal authorizations to nursing agencies who are contracted or have letter of agreement on file to perform home infusion nursing visits for patients.

Issues initial and renewal authorizations in a timely manner.

Generates letters of agreement to uncontracted nursing agencies when applicable.

Interface with other departments as needed to confirm bundled or unbundled patient status.

Generates billing documentation based on payer, utilization of Insurances Requiring Signed Plan of Treatment list.

Timely follow up of billing documentation, collaboration with billing department and physician offices.

Ensures timely filling of billing documentation into electronic filing system.

Takes the initiative to present ideas / suggestions to management.

Utilizes appropriate communication lines in relaying problems, concerns, questions, and ideas.

Demonstrates the ability to work effectively and maintain expected productivity.

Cooperates with other staff members when planning and organizing daily activities.

Always maintains courteous demeanor.

Prioritizes and completes work on schedule.

Meets quality standards, shows pride in performance, and demonstrates reliability and follow-through on all assigned tasks.

Demonstrates ability to communicate effectively and express ideas clearly.

Performs in accordance with system-wide competencies / behaviors.

Performs other duties as assigned.

Skills & Abilities

Team player

Gives high priority to client satisfaction and customer needs. Maintains confidentiality of patient information.

Provides customer service to all internal and external customers.

Good verbal and written communication skills.

Computer literate, with the ability to utilize standard software applications including Windows and MS Office Suite (Outlook, Word, and Excel)

Good organizational skills with attention to detail and ability to multitask

Requirements

HS diploma or GED required.

1+ years of pharmacy and / or other related experience in a physician practice, ancillary provider, or other relevant healthcare setting required.

Knowledge of medical terminology required.

Proficient computer skills and Microsoft Office Products required.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.