Benefits and Authorizations Specialist Lead

Job Summary: The Benefits Specialist Lead is responsible for verifying patient insurance coverage, submitting pre-authorizations, and financial assistance support  to ensure patients receive coverage for medical and infusion services provided.

Key Responsibilities:

• Verify and document insurance eligibility, benefits, and coverage for all office visits and infusion services.

• Obtains insurance authorization and pre-certification for office visits and infusion services.

• Facilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals.

• Maintains a good working knowledge of infusion drug authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization.

• Calculate and communicate patient financial responsibility.

• Provide financial assistance support to patients including identifying patient assistance programs and manufacturer copay assistance enrollment.

Qualifications:

• High school diploma or equivalent