Admissions Coordinator

This is a fully remote position, open to applicants in Colorado.

📋 Description

• Take ownership of TPN referrals from the initial intake stage through to insurance approval.

• Perform timely and precise benefit investigations to verify both medical and pharmacy benefits.

• Identify and validate coverage criteria, co-pays, deductibles, and any prior authorization requirements.

• Prepare and submit prior authorization requests to the relevant payers.

• Liaise with dieticians, sales representatives, and prescribers concerning referral status and any outstanding information.

• Coordinate and provide financial counseling to patients, covering out-of-pocket expenses, financial assistance options, and subsequent steps.

• Ensure all documentation adheres to payer and regulatory standards.

• Update referral records in real-time within the computer system.

• Collaborate with patient services and revenue cycle management (RCM) teams to facilitate a smooth transition to fulfillment.

• Monitor and report on referral statuses, turnaround times, and resolution outcomes for continuous process improvement.

• Act as a primary liaison among patients, providers, pharmacy staff, and the sales team.

⛳️ Requirements

• High school diploma or GED is mandatory; Associate’s or Bachelor’s degree is preferred.

• A minimum of 2 years of experience in healthcare, specialty pharmacy, or insurance verification is required.

• Experience with specialty medications, particularly in benefit verification and prior authorization processes, is essential.

• Background in patient-facing roles is advantageous, especially those involving financial or benefit discussions.

• Familiarity with payer portals is a must.

• Strong comprehension of commercial, Medicare, and Medicaid insurance plans is required.

• A proven ability to communicate effectively with both internal and external stakeholders is necessary.

• Experience with Microsoft BI is a plus.

• Proficiency in Outlook, Word, and PowerPoint is desirable.

• Must be able to work Monday to Friday, from 8:30 am to 5:00 pm.

• Ability to sit for prolonged periods and type on a keyboard; occasional standing and walking is required.

• Ability to push/pull and lift/carry between 1-10 lbs is necessary.

• Willingness and ability to travel up to 25% is required.

🏝️ Benefits

• Medical, Dental, and Vision insurance.

• Health Savings and Flexible Spending Accounts (up to $5,000 for childcare).

• Tuition discounts and reimbursement opportunities.

• 401(k) plan.

• Company Paid Time Off*.

• Shift Differential.

• DailyPay option.

• Pet Insurance coverage.

• Employee wellness and discount programs available.