Remote Prior Authorization Specialist: Fast Case Wins

Remote Jobs; Sandy (UT); Remote; USD 33,000 - 39,000; Full time

Benefits offered by this job

401(k) Matching

Health, Vision, and Dental Insurance

Paid time off

Community service day

Job summary

Pure Infusion is seeking a Prior Authorization Specialist to manage the authorization process, review policies, and coordinate with clinicians to ensure timely treatment for patients. This role requires strong organizational skills and familiarity with payer policies and medical benefits.

You will handle at least 30 active authorizations, navigate Salesforce, WeInfuse, and AMD, and communicate effectively with providers, patients, and internal teams to keep cases moving toward approval.

Qualifications

• Minimum 2-3 years of experience as a Medical Assistant with direct prior authorization and biologic therapy experience.
• Experience with systems like Salesforce, WeInfuse, and AMD.
• Certification or formal training as a Medical Assistant is required.

Responsibilities

• Process prior authorizations accurately and efficiently, including reviewing step therapy and payer requirements.
• Manage appeals and denials, escalating cases when necessary.
• Analyze insurance policies and obtain documentation when cases do not align with policy.
• Verify insurance benefits and determine INN or OON status across payers.
• Evaluate medical and pharmacy benefits to determine patient eligibility.

Skills

Medical Assistant

Prior authorization

Biologic therapy

Education

High School diploma or equivalent

Medical Assistant certification

Tools

Salesforce

WeInfuse

AMD

EMR/CRM systems

Job description

Pure Infusion is seeking a Prior Authorization Specialist to manage the authorization process, review policies, and coordinate with clinicians to ensure timely treatment for patients. This role requires strong organizational skills and familiarity with payer policies and medical benefits.

You will handle at least 30 active authorizations, navigate Salesforce, WeInfuse, and AMD, and communicate effectively with providers, patients, and internal teams to keep cases moving toward approval.