Authorization Specialist

violet health | Infusion Care; Sylvan Lake (MI); On-site; USD 30,000 - 41,000; Full time

Benefits offered by this job

Competitive hourly rate

Medical, dental and vision benefits

401(k) starting January 2026

Paid time off (PTO) and holidays

Ongoing training and professional成长

Job summary

violet health | Infusion Care in Michigan seeks a proactive Patient Intake & Prior Authorization Specialist to manage front-end onboarding, eligibility verification, and insurance prior authorizations. You will collaborate with clinicians and payers, ensuring timely authorizations and accurate documentation while upholding HIPAA standards.

In this role, you will gather clinical notes, coordinate with medical staff, resolve coverage issues, and communicate clearly with patients about costs and

Qualifications

• 2+ years in healthcare intake, patient access, prior authorization, or medical billing/scheduling.
• Strong understanding of prior authorization workflows and payer portals.
• Familiarity with ICD-10, CPT, and HCPCS terminology.

Responsibilities

• Intake & Registration: collect and enter patient demographics and insurance into the EHR.
• Insurance Verification: confirm active coverage, copays, deductibles, and network status.
• Prior Authorization Management: prepare, submit, and track PA requests.
• Clinical Coordination: obtain clinical docs and letters of medical necessity.
• Denial Resolution: monitor denials, draft appeals, and schedule peer reviews.
• Patient Communication: inform patients about status, coverage limits, and costs.
• Compliance & Recordkeeping: adhere to HIPAA and payer timelines.

Skills

Communication

Phone etiquette

Attention to detail

Multitasking

Education

High school diploma or equivalent

Associate degree preferred

Tools

Epic

Athenahealth

Cerner

Kareo

Job description

Position Overview

We are seeking a proactive, highly organized Patient Intake & Prior Authorization Specialist to manage the front-end patient onboarding and coverage approval process. In this dual-focus role, you will verify patient eligibility, register incoming referrals, secure insurance prior authorizations, and coordinate directly with clinical teams and third-party payers.

Key Responsibilities

• Intake & Registration: Accurately collect and enter demographic, clinical, and insurance information for new and returning patients into the Electronic Health Record (EHR) system.
• Insurance Verification: Verify active coverage, copayments, coinsurance, deductibles, and network status across commercial plans, Medicare, and Medicaid.
• Prior Authorization Management: Prepare, submit, and track prior authorization requests for specialist consultations, procedures, diagnostic tests, and pharmaceuticals according to payer-specific criteria.
• Clinical Coordination: Collaborate with physicians, nurses, and medical assistants to obtain necessary clinical documentation, chart notes, and letters of medical necessity.
• Denial Resolution & Peer-to-Peer Support: Monitor pending authorization requests, identify root causes for initial coverage denials, assist in drafting appeals, and schedule peer-to-peer clinical reviews when needed.
• Patient Communication: Keep patients informed regarding the status of their authorizations, explain coverage limitations or out-of-pocket responsibilities clearly, and maintain compassionate customer service.
• Compliance & Recordkeeping: Adhere strictly to HIPAA guidelines, payer compliance timelines, and organizational protocols for document handling.

Qualifications & Requirements

• Experience: 2+ years of experience in healthcare intake, patient access, prior authorization, or medical billing/scheduling.
• Insurance Knowledge: In-depth understanding of prior authorization workflows, payer portals (Availity, CoverMyMeds, payer-specific web portals), and medical terminology (ICD-10, CPT, and HCPCS codes).
• Systems Proficiency: Hands-on experience working with EHR/Practice Management platforms (e.g., Epic, Athenahealth, Cerner, or Kareo).
• Skills: Excellent communication and phone etiquette, strong attention to detail, and the ability to multitask in a fast-paced environment.
• Education: High school diploma or equivalent required; associate degree or relevant medical administrative certification preferred.

What We Offer

• Competitive hourly rate /based on experience.
• Comprehensive medical, dental, and vision benefits.
• 401(k) starting January 2026
• Paid time off (PTO) and paid holidays.
• Ongoing training and professional growth opportunities.