Managed Care Coordinator- Infusions/Prior Authorizations in GI

Job Overview
We are seeking a dedicated and detail-oriented Managed Care Coordinator specializing in GI infusions and prior authorizations for GI procedures. The ideal candidate will possess a comprehensive understanding of managed care processes, medical office procedures, and insurance protocols. In this role, you will serve as a vital link between healthcare providers, insurance companies, and patients to facilitate seamless authorization processes for infusion therapies and other medical services.

Responsibilities

• Review and process prior authorization requests for infusion treatments, ensuring all necessary documentation is complete and accurate.
• Verify insurance coverage and benefits for patients, including eligibility checks and benefit investigations.
• Collaborate with healthcare providers to obtain required medical records, CPT (Current Procedural Terminology) codes, ICD (International Classification of Diseases) codes (ICD-9, ICD-10), and supporting documentation for authorization submissions.
• Maintain detailed records of authorization statuses, approvals, denials, and appeals within the medical records system.

Qualifications

• Proven minim 2 years experience in managed care coordination or medical office administration with a focus on prior authorizations.
• Strong knowledge of managed care policies, insurance verification procedures, and medical coding systems including CPT, ICD-9, ICD-10, and ICD coding standards.
• Familiarity with medical terminology, medical records management, and healthcare compliance regulations such as HIPAA.
• Previous office experience in a healthcare setting is highly desirable; dental office experience is a plus.
• Knowledge of infusion therapy procedures or experience working within infusion centers is advantageous but not mandatory. Join our team as we deliver exceptional patient care through precise coordination of managed care processes—ensuring timely access to vital infusion therapies while maintaining the highest standards of professionalism and compliance!

Pay: $20.00 - $26.25 per hour

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person