Prior Authorization Specialist: Drive Timely Patient Care

Pure Infusion; Phoenix (AZ); On-site; USD 60,000 - 75,000; Full time

Job summary

Pure Infusion Suites is seeking a meticulous Prior Authorization Specialist in Phoenix to manage a caseload of 30+ active authorizations. You will review step therapy, payer policies, and coordinate with providers, payers, and internal teams to secure timely approvals.

Candidates should have 2–3 years as a Medical Assistant with prior authorization and strong experience with Salesforce, WeInfuse, and AMD. Excellent communication and organization are essential for success in this role.

Qualifications

• 2–3 years of experience as a Medical Assistant with direct prior authorization experience.
• Experience interpreting commercial and Medicare Advantage policies and LCDs.
• Proficient with EMRs/CRMs and prior authorization systems; strong documentation habits.

Responsibilities

• Process prior authorizations accurately, review step therapy and payer requirements.
• Manage appeals and denials, escalating when necessary, following payer protocols.
• Analyze policies and gather documentation to align cases with coverage.
• Verify benefits and INN/OON status across payers and states.
• Evaluate medical and pharmacy benefits for patient eligibility.
• Maintain professional communication with providers, patients, and teams.
• Document all case conversations and updates in Salesforce timely.
• Prioritize and manage authorization workload to meet deadlines.
• Collaborate with PACs, clinical staff, and sales to clarify cases.
• Investigate and resolve complex cases with strong problem-solving.
• Organize workload to meet performance goals.
• Follow Intake standards for accuracy and completion.

Skills

Medical Assistant

Prior Authorization

Salesforce

WeInfuse

AMD

Communication

Education

High School Diploma

Medical Assistant Certification

Tools

Salesforce

WeInfuse

AMD

Job description

Pure Infusion Suites is seeking a meticulous Prior Authorization Specialist in Phoenix to manage a caseload of 30+ active authorizations. You will review step therapy, payer policies, and coordinate with providers, payers, and internal teams to secure timely approvals.

Candidates should have 2–3 years as a Medical Assistant with prior authorization and strong experience with Salesforce, WeInfuse, and AMD. Excellent communication and organization are essential for success in this role.