Infusion Prior Authorization Specialist Solve Payer Puzzles

AleraCare Holdings, LLC; Boise (ID); On-site; USD 34,000 - 55,000; Full time

Benefits offered by this job

401(k) Matching

Health, Vision, and Dental Insurance

Over 20 days of paid time off annually

One paid community service day

Job summary

Pure Infusion is seeking a proactive Prior Authorization Specialist to manage the prior authorization process and ensure timely access to infusion therapies for patients. You will interpret medical benefits, review clinical documentation, and coordinate with providers and teams to obtain approvals.

The role requires strong organizational, communication, and problem-solving skills, with experience using Salesforce, WeInfuse, and AMD.

Qualifications

• Solid understanding of medical benefits, step therapy, and authorization policies.
• Ability to interpret clinical documentation and payer policies.
• Experience managing a caseload of active authorizations.

Responsibilities

• Efficiently manage the prior authorization process to ensure timely patient care.
• Collaborate with providers, clinical teams, and internal stakeholders to move cases forward.
• Navigate payer policies and paperwork to obtain approvals.

Skills

Organizational skills

Communication

Problem solving

Payer policy knowledge

Tools

Salesforce

WeInfuse

AMD

Job description

Pure Infusion is seeking a proactive Prior Authorization Specialist to manage the prior authorization process and ensure timely access to infusion therapies for patients. You will interpret medical benefits, review clinical documentation, and coordinate with providers and teams to obtain approvals.

The role requires strong organizational, communication, and problem-solving skills, with experience using Salesforce, WeInfuse, and AMD.