Prior Authorization Pro — Infusion Pharmacy

Remote Jobs; Tucson (AZ); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical, dental, vision plans

PTO & holidays

401(k) matching

Tuition reimbursement

Volunteer days off

Life insurance (basic)

Disability insurance (long-term)

Employee assistance program

Employee referral program

Job summary

Vital Care Infusion Services is seeking a dedicated Authorization Specialist to initiate authorizations, focusing on accuracy and timely processing to reduce denials and improve collection rates. You will work with franchise partners, payers, and internal teams to ensure complete documentation and prompt responses to insurers.

The role requires two years of intake/authorization and home infusion therapy experience, with strong communication and organizational skills, and proficiency in MS Office

Qualifications

• Two years’ experience in intake/authorizations and home infusion therapy.
• High school diploma or equivalent.

Responsibilities

• Review patient files for completeness and accuracy, ensure all revenue opportunities are included to complete and submit prior authorizations timely for payer reimbursement.
• Communicate effectively with franchise partners, payers, and other departments regarding the status of authorizations.
• Document case activity, communications, and correspondence in the system to ensure completeness and accuracy of account activity and actions taken to resolve outstanding authorization issues; schedule follow-ups as required.
• Investigate and verify benefits for pharmacy and medical third-party claims.
• Obtain reauthorizations; initiate requests, follow up to provide additional required information, and track progress with payers; maintain contact with customers to keep them informed.
• Track, report, and escalate service issues arising from authorization requests or other issues delaying service to ensure patient access and avoid therapy interruptions.
• Communicate financial obligation information with patients so they understand therapy costs before starting service.
• Perform other related duties as assigned.

Skills

Communication skills

Billing & collections

Documentation & records

Organizational skills

MS Office & pharmacy apps

Education

High school diploma

Tools

MS Office

Pharmacy software

Job description

Vital Care Infusion Services is seeking a dedicated Authorization Specialist to initiate authorizations, focusing on accuracy and timely processing to reduce denials and improve collection rates. You will work with franchise partners, payers, and internal teams to ensure complete documentation and prompt responses to insurers.

The role requires two years of intake/authorization and home infusion therapy experience, with strong communication and organizational skills, and proficiency in MS Office