Overview
Lakeshore Dermatology is Hiring - Full Time Biologics / Prior Authorization Coordinator !!
Monday - Friday Schedule 8:00 AM - 5:00 PM - off @ 12 pm on Friday's One day weekly in Grand Rapids
The Prior Authorization Coordinator is responsible for managing prior authorizations and prescription workflows for medications, including biologics. This role ensures timely insurance approvals, accurate documentation, and coordination of medication delivery to support patient care and clinician treatment plans. The coordinator collaborates with clinicians, patients, pharmacies, and pharmaceutical representatives to facilitate efficient medication access.
Responsibilities
- Initiates and manages prior authorizations for medications, including biologics.
- Communicates authorization status, approvals, and denials with patients and documents all interactions in the medical record.
- Gathers and submits required clinical documentation to support insurance authorization requests.
- Coordinates patient scheduling and testing in alignment with treatment plans and medication timelines.
- Verifies medication receipt prior to patient appointments.
- Collaborates with clinicians and pharmaceutical representatives to stay current on therapies and access processes.
- Supports phone triage functions, including call management, medication requests, authorizations, and scheduling.
- Maintains compliance with organizational policies and completes required training.
- Performs additional duties as assigned.
- Biologics responsibilities
- Manages biologic medication access and initiation workflows, including coordinating enrollment in manufacturer patient support programs, copay assistance programs, and other available resources to support patient access to prescribed therapies.
- Coordinates biologic medication procurement and fulfillment by working with specialty pharmacies, infusion centers, and medication distributors, as applicable, to monitor prescription status, resolve access barriers, and ensure medications are available in alignment with scheduled treatments.
- Tracks biologic authorization requirements and renewal timelines, including reauthorizations, continuation-of-therapy requests, and required clinical documentation, to minimize treatment delays or interruptions.
- Collaborates with clinicians and patients to facilitate biologic treatment readiness, including coordinating required baseline testing, monitoring documentation, and follow-up requirements in accordance with the prescribed treatment plan and applicable payer guidelines
Qualifications
Required Competencies and Skills
- 1+ years of medical billing, dermatology, or related patient care experience preferred. Strong attention to detail and organizational skills.
- Effective verbal and written communication skills.
- Ability to manage multiple priorities in a fast-paced clinical environment.
- Proficiency in Microsoft Office applications and ability to learn new systems quickly.
- Ability to work independently and collaboratively within a team.
- Demonstrated professionalism, adaptability, and accountability.
- Ability to maintain confidentiality and handle sensitive information appropriately.
Education & Experience
- Required Education: High School Diploma or GED.
- Preferred Education: Bachelor's Degree.
#INDJOS Forefront Dermatology is committed to providing equal employment opportunity and maintaining a workplace for employees and applicants that is free from discrimination based upon age, race, religion, color, disability, marital status, sex (including pregnancy), national origin, ancestry, ethnicity, sexual orientation, gender identity or expression, genetic information, veteran or military status, or any other status protected by applicable federal, state, or local law.
If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, please contact hr@forefrontderm.com to let us know the nature of your request and your contact information.