Prior Authorization Coordinator

The Prior Authorization Coordinator ensures seamless patient care by maintaining prior authorizations, copay assistance, and verifying existing insurance coverage for ongoing services. Responsibilities include:

Must have a solid working knowledge of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits

Verify insurance benefit information monthly via multiple methods such as online tools, calling payors or processing test claims

Generates a prior authorization expiration report weekly, bi-weekly, or monthly

Review clinical documents for prior authorization/pre-determination submission purposes

Secures prior authorization, pre-determination, or medical review

Contact prescriber’s office to obtain information that is required to complete ongoing re-authorization and verification of benefits

Places outbound calls to patients or prescriber’s offices to notify of any delays due to more information needed to process or due to a prior authorization

Document insurance coverage of medications, administration supplies, and related infusion services including prior authorization requirements and coordination of benefits

Provides exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner

Ensures the appropriate notification of patients in regards to their financial responsibility, benefit coverage, and payor authorization for services to be provided

Generates patient forms

Maintains up to date prior authorization report

Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!

Improve patients’ lives every day

Be passionate in everything you do

Encourage unlimited ideas and creative thinking

Make decisions as if you own the company

Do the right thing

Have fun!

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.