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Infusion Prior Authorization Jobs in Wisconsin (NOW HIRING)

Regeneron Pharmaceuticals, Inc

WI · On-site

$183.10 - $305.20/hr

Prior experience with infusion biologic launches in hospital/outpatient infusion settings. * Knowledge of specialty pharmacy hub operations, patient assistance programs, and prior authorization ...

Regeneron Pharmaceuticals, Inc

WI · On-site

$183.10 - $305.20/hr

Prior experience with infusion biologic launches in hospital/outpatient infusion settings. * Knowledge of specialty pharmacy hub operations, patient assistance programs, and prior authorization ...

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Infusion Prior Authorization information

What is an infusion prior authorization specialist?

An Infusion Prior Authorization specialist is a healthcare professional responsible for obtaining approval from insurance companies for patients to receive infusion therapies. They review medical records, collaborate with providers, and ensure all necessary documentation is submitted to meet insurance requirements. Their work helps patients access important treatments while minimizing delays and out-of-pocket costs. They also communicate with both patients and insurance representatives to resolve any issues related to coverage or denials.

What are the typical challenges faced in an infusion prior authorization role, and how can they be managed?

Professionals in Infusion Prior Authorization often encounter challenges such as navigating complex insurance requirements, managing high volumes of requests, and ensuring timely approvals to prevent delays in patient care. Staying organized, maintaining clear communication with providers and payers, and keeping up-to-date on changing insurance policies can help address these challenges. Additionally, close collaboration with clinical teams and ongoing training in authorization systems are key to efficiently managing the workload and supporting positive patient outcomes.

What are the key skills and qualifications needed to thrive as an infusion prior authorization specialist, and why are they important?

To excel as an Infusion Prior Authorization Specialist, you need a thorough understanding of medical terminology, insurance policies, and healthcare regulations, often supported by a background in healthcare administration or billing. Familiarity with prior authorization software, electronic health records (EHR), and payer portals is typically required. Strong attention to detail, organizational skills, and effective communication are essential soft skills for navigating complex documentation and coordinating with providers and insurers. These competencies ensure timely approvals, reduce delays in patient care, and help healthcare organizations maintain compliance and reimbursement efficiency.

What is the difference between Infusion Prior Authorization vs Pharmacist?

AspectInfusion Prior AuthorizationPharmacist
CredentialsTypically requires healthcare licensing, certification in infusion therapyRequires pharmacy degree, licensure, and certification
Work EnvironmentHospitals, clinics, infusion centersPharmacies, hospitals, healthcare facilities
Industry UsageInsurance approval process for infusion treatmentsMedication dispensing, patient counseling, medication management

Infusion Prior Authorization involves obtaining insurance approval for infusion therapies, focusing on approval processes. Pharmacists dispense medications and provide patient counseling. While both roles require healthcare credentials, infusion prior authorization specialists focus on insurance and approval procedures, whereas pharmacists handle medication management and dispensing.

How do I become an infusion prior authorization specialist?

To become an infusion prior authorization specialist, candidates typically need a high school diploma or equivalent, along with knowledge of medical billing, insurance processes, and prior authorization procedures. Relevant skills include attention to detail, communication, and familiarity with electronic health record (EHR) systems; some roles may require certification in medical billing or coding. On-the-job training is common, and experience in healthcare or insurance can improve job prospects.

Is infusion prior authorization a stressful job?

Infusion prior authorization is a role that involves reviewing medical documentation and coordinating with healthcare providers to approve infusion treatments. The job can be stressful due to tight deadlines, high accuracy requirements, and the need to manage complex insurance policies. Strong organizational skills and attention to detail are important to succeed in this position.

What are popular job titles related to Infusion Prior Authorization jobs in Wisconsin?

For Infusion Prior Authorization jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Infusion Prior Authorization jobs in Wisconsin look for?

The top searched job categories for Infusion Prior Authorization jobs in Wisconsin are:

What cities in Wisconsin are hiring for Infusion Prior Authorization jobs?

Cities in Wisconsin with the most Infusion Prior Authorization job openings:

Infusion Prior Authorization jobs near you

Therapy Care Specialist - Specialty Infusion Pharmacy Technician

Soleo Health Inc

Pewaukee, WI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 27 days ago

Job description

Description

Soleo Health is seeking a Therapy Care Specialist to support our specialty infusion pharmacy in Pewaukee, WI. Join us in Simplifying Complex Care!  


**Must be able to work 100 percent in office**



Soleo Health Perks:

  • Competitive Wages  
  • 401(k) with a Match 
  • Referral Bonus    
  • Paid Time Off 
  • Great Company Culture  
  • Annual Merit Based Increases 
  • No Weekends or Holidays   
  • Paid Parental Leave Options 
  • Affordable Medical, Dental, & Vision Insurance Plans 
  • Company Paid Disability & Basic Life Insurance 
  • HSA & FSA (including dependent care) Options 
  • Education Assistance Program   


The Position:

The Therapy Care Specialist will work with SoleoRx TCMC model and utilize national and local resources to facilitate high quality care of a patient with specialty pharmacy needs. The Therapy Care Specialist will work under the supervision of a Pharmacist to oversee logistics of a patient's dispense and prescription maintenance, assessment data capture, and serves as the point person to coordinate patient care across all layers of the patient care continuum while on service with Soleo Health. Responsibilities include:

  • Act as single point of contact for specialty patients and as liaison with Soleo branch personnel to coordinate timely medication dispense and delivery
  • Works under supervision of specialty pharmacist and/or branch pharmacist to capture assessment data, ascertain patients supply needs, and schedule new and refill medication deliveries
  • Run daily and weekly pharmacy reports as needed
  • Answer phones and warm transfer call to appropriate location, monitor incoming faxes, and monitor TCMC refill queues
  • Send orders to physicians for signature 
  • Work with intake/reimbursement staff to maintain active patient insurance coverage and actively pursue authorizations and re-authorizations with the auth/billing staff at the branch level
  • Documentation of all patient interaction and care coordination in the designated system of record for clear and consistent communication
  • Complete therapy specific training as required

Schedule:

  • Must be able to work 100% in-office
  • Must be able to work Full-time, Monday-Friday 8:30am-5pm CST, 40 hours per week
  • Must be a Licensed/Registered Pharmacy Technician for the state of Wisconsin
  • Preferred PTCB or NHA Certification
  • Preferred experience with scheduling deliveries for Specialty Infusion Pharmacy patients

Requirements

  • Prior experience in home infusion, compounding and/or specialty pharmacy required
  • High School Diploma or equivalent
  • Registered/Licensed Pharmacy Technician license required for the state of Wisconsin in goodstanding
  • PTCB/NHA Certification Preferred
  • Prior experience scheduling patient refill deliveries, preferred experience with home infusion
  • Prior customer service/patient services experience
  • Basic to intermediate efficiency with Microsoft Excel, Word and Outlook (Experience with CPR+, Insight, Citus, Genesys, and Paylocity preferred)



About Us: 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! 



Soleo's Core Values:

  • 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.



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