Remote Prior Authorization Specialist – Infusion Therapy

AleraCare Holdings, LLC; Sandy (UT); Remote; USD 33,000 - 39,000; Full time

Benefits offered by this job

Competitive hourly rate

401(k) Matching

Health, Vision, and Dental Insurance

Over 20 days of paid time off annually

Community service day

Job summary

Pure Infusion is seeking a dedicated Prior Authorization Specialist to manage a caseload of active authorizations and navigate systems like Salesforce, WeInfuse, and AMD. You will ensure timely approvals, accurate steps, and clear communication with providers and patients.

The role emphasizes interpreting clinical documentation, payer policies, and complex cases, delivering efficient patient care and supporting a patient-first culture.

Qualifications

• Minimum 2-3 years of experience as a Medical Assistant (MA) with direct prior authorization and biologic therapy experience.
• Strong experience with Salesforce, WeInfuse, and AMD.
• Certification or formal training as a Medical Assistant is required.
• High School diploma or equivalent is required.

Responsibilities

• Process prior authorizations accurately and efficiently, including reviewing step therapy and payer requirements.
• Manage appeals and denials, escalating cases when necessary and following payer protocols.
• Analyze policies and obtain needed documentation when cases do not align with policy.
• Verify insurance benefits and determine INN or OON status across payers and states.
• Maintain clear, professional communication with providers, patients, internal teams, and stakeholders.
• Document all case-related conversations and updates in Salesforce within required timeframes.
• Collaborate with internal teams to gather or clarify case information.
• Investigate and resolve complex cases using critical thinking and problem-solving skills.

Skills

Medical Assistant experience

Prior authorization experience

Detail oriented

Clear communication

Education

High School diploma or equivalent

Certified Medical Assistant

Tools

Salesforce

WeInfuse

AMD

Job description

Pure Infusion is seeking a dedicated Prior Authorization Specialist to manage a caseload of active authorizations and navigate systems like Salesforce, WeInfuse, and AMD. You will ensure timely approvals, accurate steps, and clear communication with providers and patients.

The role emphasizes interpreting clinical documentation, payer policies, and complex cases, delivering efficient patient care and supporting a patient-first culture.