Infusion Referrals & Authorization Specialist (Remote)

UnityPoint Health; Springfield (IL); Remote; USD 45,000 - 65,000; Full time

Benefits offered by this job

Paid time off

Parental leave

401K matching

Dental and health insurance

Daily Pay

Tuition reimbursement

Adoption assistance

Pet insurance

Job summary

UnityPoint Health is seeking a Referral and Authorization Coordinator - Infusion Services to manage new referrals, coordinate authorizations, and ensure timely access to infusion therapies across our ambulatory infusion enterprise.

You will enter referral data into the EMR, evaluate medical necessity, collaborate with providers and payers, and support appeals, financial assistance resources, and patient cost-share guidance to minimize treatment delays and improve the patient experience.

Qualifications

• High School Diploma or GED required.
• 2 years experience with benefit investigations, formulary reviews, and prior authorization workflows.
• 2 years infusion services, specialty pharmacy, or high-cost medication workflows preferred.
• EMR and payer portal experience preferred.
• 1 year medical experience, preferably in community health, home health or pharmacy, required.

Responsibilities

• Manage infusion service referrals, including intake, scheduling, medication coordination, and timely communication with patients and referring providers.
• Conduct insurance eligibility and benefit investigations, including formulary reviews and cost-share assessments.
• Submit and monitor prior authorizations, obtain clinical documentation, and follow up with payers for timely approvals.
• Review authorization denials, coordinate appeals, and suggest alternative therapies when needed.
• Coordinate with medication assistance advocates to connect patients with financial resources to reduce barriers.
• Maintain relationships with patients, providers, referral sources, pharmacies, and internal teams; direct inquiries appropriately.
• Provide excellent customer service, maintain accurate documentation, and support process improvements.

Education

High School Diploma/GED

Pharmacy technician certification or registration (Iowa, Illinois, Wisconsin)

Job description

UnityPoint Health is seeking a Referral and Authorization Coordinator - Infusion Services to manage new referrals, coordinate authorizations, and ensure timely access to infusion therapies across our ambulatory infusion enterprise.

You will enter referral data into the EMR, evaluate medical necessity, collaborate with providers and payers, and support appeals, financial assistance resources, and patient cost-share guidance to minimize treatment delays and improve the patient experience.