Job Description
Job Description
Overview
The Specialty Admission Coordinator is responsible for managing specialty medication referrals from receipt through insurance clearance to ensure timely and accurate patient access to therapy. This role serves as the key point of contact for benefit investigation, prior authorization, coordination with internal stakeholders (pharmacy and nursing staff) and financial counseling with patients. The coordinator plays a critical role in ensuring referrals meet payer requirements and in facilitating seamless communication between patients, providers, pharmacy staff and the sales team.
Schedule : Monday - Friday
8 : 30am - 5 : 30pm
- Competitive Pay
- Health, Dental, Vision & Life Insurance
- Company-Paid Short & Long-Term Disability
- Flexible Schedules & Paid Time Off
- Tuition Reimbursement
- Employee Discount Program & DailyPay
- 401k
- Pet Insurance
Responsibilities
Owns and manages the specialty referral from initial intake through insurance approvalConducts timely and accurate benefit investigation, verifying both medical and pharmacy benefitsIdentifies and confirms coverage criteria, co-pays, deductibles and prior authorization requirementsPrepares and submits prior authorization requests to appropriate payersMaintains clear, timely communication with pharmacy teams, sales representatives and prescribers regarding the status of each referral and any outstanding informationCoordinates and delivers financial counseling to patients, including explanation of out-of-pocket costs, financial assistance options and next stepsEnsures all documentation complies with payer and regulatory requirementsUpdates referral records in real-time within computer systemCollaborates with patient services and RCM teams to support a smooth transition to fulfillmentTracks and reports referral statuses, turnaround times and resolution outcomes to support process improvementSupervisory Responsibility : NoQualifications
EDUCATION / EXPERIENCE
High school diploma or GED required; Associate’s or Bachelor’s degree preferred.Minimum of 2 years of experience in a healthcare, specialty pharmacy, or insurance verification role.Experience working with specialty medications, including benefit verification and prior authorization processes.Experience in patient-facing roles is a plus, especially involving financial or benefit discussion.KNOWLEDGE / SKILLS / ABILITIES
Familiarity with payer portals.Strong understanding of commercial, Medicare, and Medicaid insurance plans.Proven track record of communicating effectively with internal and external stakeholders.Desired : Experience in Microsoft BI. Experience in Outlook, Word, and PowerPoint.TRAVEL REQUIREMENTS
Percentage of Travel : 0-25%
To perform this role will require constant sitting and typing on a keyboard with fingers, and occasional standing, and walking. The physical requirements will be the ability to push / pull and lift / carry 1-10 lbs