Infusion Meds Prior Authorization Specialist

Thrivewell Infusion, LLC; Washington Heights (NY); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Competitive salary based on experience

Healthcare coverage + retirement plans

Paid time off

Professional development opportunities

Collaborative work environment

Job summary

Thrivewell Infusion, LLC is seeking an Authorization Expert to obtain prior authorizations for medications used in infusion therapy of rare and chronic diseases. You will work on-site, collaborating with care teams to ensure timely approvals and continuity across treatment cycles.

You will review insurance policies, request necessary clinical information, and manage follow-ups with payers to minimize denial rates while maintaining meticulous EMR records.

Qualifications

• Bachelor's degree preferred.
• Minimum 3 years of healthcare experience focusing on prior authorizations for high-value medications.
• Experience in healthcare administration or authorization coordination required.
• Strong knowledge of insurance policies and guidelines for prior authorizations.
• Excellent communication and interpersonal skills.
• Proficiency in medical management systems and MS Office.
• Ability to work independently and as part of a team.
• Detail-oriented and organized.

Responsibilities

• Prepare and submit prior authorization requests to insurance companies with complete documentation.
• Collaborate with departments to obtain necessary clinical information for prior authorizations.
• Review policies and guidelines to determine requirements for approvals and maintain continuity.
• Identify required documents for approvals across various payers.
• Follow up on requests, including denials and appeals, to secure timely approvals.
• Maintain accurate records of prior authorizations in EMR and support software.
• Assist procurement by logging deliveries of toxic medications.

Skills

Prior authorizations

Healthcare experience

Communication

EMR proficiency

Detail-oriented

Team collaboration

Education

Bachelor's degree preferred

Tools

EMR systems

Microsoft Office

Medical management systems

Job description

Thrivewell Infusion, LLC is seeking an Authorization Expert to obtain prior authorizations for medications used in infusion therapy of rare and chronic diseases. You will work on-site, collaborating with care teams to ensure timely approvals and continuity across treatment cycles.

You will review insurance policies, request necessary clinical information, and manage follow-ups with payers to minimize denial rates while maintaining meticulous EMR records.