Prior Authorization Specialist: Drive Timely Patient Care

Aleracare; Sandy (UT); On-site; USD 33,062 - 38,572; Full time

Job summary

Pure Infusion Suites is seeking a detail-oriented Prior Authorization Specialist to manage a caseload of active authorizations and ensure timely treatment. You will navigate medical benefits, step therapy, and payer policies with strong organization and communication.

Collaboration with providers, PACs, and sales teams is essential to maintain patient satisfaction. The role requires a solid MA background, experience with prior authorization systems, and proficiency in Salesforce and EMR

Qualifications

• Must be a licensed or certified Medical Assistant with relevant experience.
• Experience interpreting medical benefits and payer policies including LCDs is required.
• Proficiency with Salesforce, WeInfuse and AMD is essential.

Responsibilities

• Process prior authorizations accurately, reviewing step therapy and payer requirements.
• Manage appeals/denials and escalate when needed, following payer protocols.
• Review policies and obtain documentation when cases misalign with policy.
• Verify benefits and in-network/out-of-network status across payers and states.
• Communicate clearly with providers, patients, and internal teams; document all updates in Salesforce.

Skills

Medical Assistant

Prior Authorization

Biologic therapy

Insurance policies

Communication skills

Education

High School diploma

MA Certification

Tools

Salesforce

WeInfuse

AMD

EMR systems

Job description

Pure Infusion Suites is seeking a detail-oriented Prior Authorization Specialist to manage a caseload of active authorizations and ensure timely treatment. You will navigate medical benefits, step therapy, and payer policies with strong organization and communication.

Collaboration with providers, PACs, and sales teams is essential to maintain patient satisfaction. The role requires a solid MA background, experience with prior authorization systems, and proficiency in Salesforce and EMR