Company: Paragon Healthcare, Inc.
Posted on: January 13, 2022
Great opportunity to join an award-winning national specialty
infusion provider, Paragon Healthcare, based in Dallas, TX. This
position supports an exclusive rare/orphan specialty product and
will be part of our ParagonRare team dedicated to this product and
program.This position is located at our home office in Plano, TX at
3033 W. President George Bush Fwy, 75075.The Benefits and
Authorization - Rare Specialist ensures accurate and timely
verification of benefits, submission of PBM claims, prior
authorization requirements collection, submission and follow up,
financial assistance enrollment and coordination with relevant
internal Paragon Healthcare teams, prescribers offices, patients
and caregivers. This position will be primarily dedicated to a
given Rare/Orphan program in most cases for a single product /
- High school diploma or equivalent (GED) required.
- Minimum of 1-2 years experience in the medical field, with a
strong working knowledge of healthcare insurance,
commercials/Medicare reimbursement, and managed care, in both
pharmacy and major medical benefits and authorization process
- Excellent interpersonal, communication, and organizational
- Ability to prioritize, multi-task, and problem solve.Major
- Responsible for delivering exceptional service to patients,
providers, and team members, including open channels of
communication, prompt response to inquiries and requests, and
timely, accurate follow up of missing documentations.
- Effectively communicate and escalate issues to the appropriate
team members for patient-centric resolutions.
- Maintain daily tasking work queue, quality assurance, and
established productivity levels with minimal errors.
- Obtain prior authorizations as required by payer, including
procurement of needed clinical documentation by collaborating with
the Patient Access team and clinical teams.
- Document all prior authorization information, including
approval dates, billing units, procedure codes, and prior
authorization number in patient profile.
- Proactively work on prior authorizations that are due to be
- Provide assistance with reimbursement inquiry requests,
including insurance benefit verification, prior authorization,
denials and appeals, ad other reimbursement issues.
- Identifies any restrictions and details on how to expedite
- Performs research and analysis of patient account issues and
strives to resolve problems timely and accurately.
- Performs other duties and special projects as assigned.Work
- Ability to work in a team setting, requiring cross-training of
- Ability to prioritize, have excellent customers service and
organizational skills with attention to detail, and the ability to
work effectively in stressful situations.
- Understands and adheres to all external accreditation review
standards, applicable state, local, and Federal laws and/or
regulations, including maintaining patient confidentiality through
abiding by HIPAA laws/regulations.
- Understands and adheres to all company policies and
- Ability to work under strict guidelines, competing priorities,
and immediate requests.
- Establishes and maintains positive working relationships with
internal and external customers as well as all company
- Displays a neat, clean, and professional appearance at all
- Handles customer/patient complaints in a fair and empathetic
Keywords: Paragon Healthcare, Inc., Plano , Benefits Specialist, Other , Plano, Texas
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