Medication Access - PHIS Authorization at Parkview Health – Fort Wayne, Indiana

This position will act as the primary interface between the Parkview Home Infusion Services (PHIS) staff and the Parkview Health (PH) Revenue Cycle team. This role is crucial for ensuring seamless communication and coordination among these teams to facilitate efficient prior authorization and financial processes.

This position will have typical daytime hours, Monday through Friday. This position will begin as onsite at the Parkview Distribution Center with a potential transition to remote work.

Key Responsibilities

Patient Intake & Authorization:

1. Initiate, complete, and document prior authorization (PA) of applicable services, supplies, and drugs based on patient need and payor requirements
2. Perform benefits investigation for patient specific services, supplies, and drugs
3. Complete re-authorization for expiring authorizations
4. Collaborate with intake coordinator to identify accounts needing re-authorization, including those infusions with schedule changes, dosage changes, or with a previous dose denial
5. Outreach to patients to confirm or clarify information as needed
6. Build/update patient profiles in PHIS software as needed
7. Assist with review of denials to identify trends in drug, service, or payor

Coordination and Communication:

1. Serve as the point of contact for day-to-day Prior Authorization needs for the PH Revenue Cycle team and PHIS staff, including nursing, intake, and pharmacy staff and the PH Revenue Cycle Team.
2. Establish and assure PHIS staff visibility into the status of all patients scheduled for service.
3. Ensure the PH Revenue Cycle team has all required information to produce timely and accurate claims.
4. Collaborate across teams to facilitate the patient financial experience, consistent with other areas within Parkview Health.

Skills and Qualifications:

• Strong communication and coordination skills
• Ability to work with multiple teams and manage complex processes
• Attention to detail and problem-solving skills
• Exceptional organizational skills
• This position will be required to complete the NHIA Infusion Revenue Cycle Basics training program as well as the ASHP Pharmacy Revenue Cycle Certificate