Authorization Specialist McKesson is in the business of better health and we touch the lives of patients in virtually every aspect of healthcare. At McKesson Specialty Health, our products and services span the full continuum of specialty patient care. From the initial phases of a product life cycle and the distribution of specialty drugs, to fully integrated healthcare technology systems, practice management support, and ultimately to patient care in the communities where they live, we empower the community patient care delivery system by helping community practices advance the science, technology and quality of care. We have a vision that the long-term vibrancy of community care will be achieved through the leadership of physicians committed to clinical excellence and innovation, enabled by close collaboration with our organization and our deep clinical, operational and technological expertise. Every single McKesson employee contributes to our missionby joining McKesson Specialty Health you act as a catalyst in a chain of events that helps millions of people all over the globe. Youll collaborate on the products and solutions that help us carry out our mission to improve lives and advance healthcare. Working here is your opportunity to shape an industry thats vital to us all. Join our team of leaders to begin a rewarding career. Position Description Authorization Specialist will be responsible for maintainingeffective communication between infusion site nurses, sales team, insuranceagents and practice organizations. Qualified candidates must haveexcellent written and verbal communication skills, advanced computer literacyand the ability to multi-task in a fast-paced work environment. Under thedirection of the Patient Access Manager, candidates will be responsible fordetermining eligibility for new and existing infusion therapy patients via verificationof insurance benefits, review of policy guidelines for coverage criteria andattainment of initial referral if required. Additionally, understandingof when pre-certifications, pre-determinations and prior authorizations arenecessary as well as how to initiate processing of each is required. Ability to evaluate profitability of infusion therapies and communicateissues is necessary. EssentialFunctions & Duties * Verifies insurance benefits for new patient referrals. * Re-verifies insurance benefits for existing patients. * Accurately evaluates charge and reimbursement estimates for infusion therapies. * Reviews all medical documentation against medical policy and initiates pre-determination, pre-certification, and authorizations as needed. * Follow-up on pending pre-certifications and/or pre-determinations until outcome decided. * Updates and maintains insurance and authorization information in billing software. * Obtains PCP referrals as needed. * Completes special projects as assigned. * Performs other job related duties as assigned. Minimum Requirements 6+ months' related experience, preferably in a healthcare organization Critical Skills ** ** * Intake/patient access experience in the healthcare industry. * Strong knowledge of insurance benefits which includes, deductibles, co-insurance, out-of-pocket, plan exclusions and prior authorization requirements; preferably in an infusion therapy setting. * Must demonstrate an understanding of reimbursement practices including government program regulation and managed care contracting. * Strong ability to communicate effectively, both orally and in writing. * Maintains clear communication with customers regarding mutual expectations - takes personal responsibility and accountability for correcting customer-service problems. * Excellent personal computing skills and a working knowledge of MS Office software. * Exceptional organizational skills and attention to detail at all times. Additional Knowledge & Skills * Ability to work well in a team dynamic as well as independently. * Adaptability to handle changing priorities in a high volume, fast-paced work environment. Education High School diploma or equivalent Physical Requirements Professional office environment Benefits & Company Statement McKesson believes superior performance individual and team that helps us drive innovations and solutions to promote better health should be recognized and rewarded. We provide a competitive compensation program to attract, retain and motivate a high-performance workforce, and its flexible enough to meet the different needs of our diverse employee population. We are in the business of better health and we touch the lives of patients in virtually every aspect of healthcare. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. But we cant do it without you. Every single McKesson employee contributes to our missionwhatever your title, whatever your role, you act as a catalyst in a chain of events that helps millions of people all over the globe. Talented, compassionate people are the future of our companyand of healthcare. At McKesson, youll collaborate on the products and solutions that help us carry out our mission to improve lives and advance healthcare. Working here is your opportunity to shape an industry thats vital to us all. McKesson is an equal opportunity and affirmative action employer minorities/females/veterans/persons with disabilities. Qualified applicants will not be disqualified from consideration for employment based upon criminal history. Agency Statement No agencies please. **Primary Location: **United States-Texas-Houston **Work Locations: ** **Job: **Medical **Organization: **McKesson Canada **Schedule: **Full-time **Job Type: **Standard **Job Posting: **Aug 8, 2018 **Shift: **Day Job