Authorization Coordinator

About Company:

Druid City Vital Care, located in Northport, Alabama, is a leading home infusion therapy pharmacy dedicated to providing safe, convenient care for patients with both acute and chronic conditions. Our services allow patients to receive high-quality infusion therapy in the comfort of their homes or alternate care sites.

Recognized for excellence in sterile drug compounding, Druid City Vital Care has earned top honors as the #1 franchise in the Vital Care network for 2023 and 2024. We are committed to delivering personalized support and comprehensive post-therapy follow-up, ensuring every patient receives exceptional care throughout their healthcare journey.

About the Role:

The Authorizations Coordinator is responsible for overseeing and managing the authorization process for home infusion services. This role ensures that all required authorizations are obtained promptly and accurately, supporting seamless patient care and compliance with insurance guidelines. The coordinator serves as a key liaison among healthcare providers, insurance companies, sales teams, and patients to facilitate timely and efficient authorization workflows.

Responsibilities:

Authorization Management

• Secure prior authorizations for home infusion services and medications from insurance providers.
• Verify patient insurance coverage and benefits specific to home infusion care.
• Ensure all required documentation is accurately submitted to insurance companies to support authorization requests.

Communication and Coordination

• Serve as a liaison between healthcare providers, patients, insurance companies, and the sales team to resolve authorization-related issues.
• Communicate authorization status and potential out-of-pocket costs to patients in a timely and clear manner.
• Collaborate with the pharmacy team to ensure accurate and prompt processing of medication orders.

Documentation and Record Keeping

• Maintain comprehensive records of authorization requests, approvals, denials, and related communications within the electronic medical record system.
• Update patient files with current authorization details and ensure compliance with regulatory and organizational standards.
• Generate and submit reports on authorization activities and outcomes to management as needed.

Compliance and Quality Assurance

• Ensure adherence to all applicable laws, regulations, and internal policies related to home infusion services and insurance authorizations.
• Participate in quality assurance initiatives to enhance the efficiency and accuracy of the authorization process.
• Stay current on changes in insurance policies, procedures, and regulations that may impact authorization workflows.

Customer Service

• Provide exceptional service to patients, healthcare providers, and insurance representatives throughout the authorization process.
• Address and resolve concerns related to insurance coverage and authorization status.
• Educate patients and providers on the authorization process, requirements, and timelines.

Required Education:

• High school diploma or equivalent.

Preferred Education (not required):

• Associate or bachelor's degree in healthcare administration, business administration, or a related field.

Experience & Skills:

• Prior experience in healthcare administration, patient intake, or a related field, preferably within a home infusion or pharmacy setting.
• Strong communication and interpersonal skills to effectively interact with patients, providers, and team members.
• Excellent organizational skills and attention to detail.
• Ability to work independently and collaboratively in a fast-paced environment.
• Proficiency in using computer systems and software, including electronic health records (EHR) and pharmacy management platforms.
• Familiarity with maintaining medical documentation in HIPAA-compliant systems

Work Authorization:

• Must be legally authorized to work in the United States without requiring employer sponsorship, now or in the future.
• Provide proof of identity and employment eligibility to complete the I-9 verification process.
• For multi-state operations, eligibility for licensure reciprocity or