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Insurance Authorization Specialist - III

Remote, USA Full-time Posted 2025-07-27
    Description:
  • Responsible for obtaining authorizations for elective infusions and injections.
  • Ensure reimbursement for the organization.
  • Utilize payor resources to verify accurate prior authorization requirements.
  • Escalate financial clearance risks as appropriate.
  • Act as a liaison between clinical teams and pharmacists for communication regarding infusion prior authorization issues.
  • Code cases and review clinical documentation for completeness.
    Requirements:
  • High school graduate or equivalent with 2 years working experience in a medical environment, (such as a hospital, doctor’s office, or ambulatory clinic.)
  • Associate’s degree and 1 year of experience in a medical environment.
  • 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes.
  • Understanding of authorization processes, insurance guidelines, and third-party payors practices.
  • Proficiency in Microsoft Office applications.
  • Excellent communication and interpersonal skills.
  • Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail.
  • Basic computer skills.

Benefits:

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