Authorization Specialist - Revenue cycle Management

Vital Care Infusion Services•Dallas, TX

About The Position

The Authorization Specialist performs duties to initiate authorizations, with an emphasis on accuracy, timeliness, and adherence to processes that reduce denial rates, days sales outstanding (DSO), and bad debt. The role minimizes turnaround time and errors to improve collection rates while working within standard or accepted practices, credentialing and re-credentialing requirements, and contract applications. The position supports timely patient access to infusion therapy by coordinating authorizations and communicating with franchise partners, payers, patients, and internal departments.

Requirements

Two years of experience in intake/authorizations and home infusion therapy.
High school diploma or equivalent.
Excellent English communication skills, including listening, speaking, understanding, and writing, with the ability to influence patients, caregivers, and payer representatives, answer questions, and advance reimbursement and collection efforts.
Understanding of processes, systems, and techniques that support successful billing and collection efforts across payer types.
Ability to identify documentation gaps and problems, determine lasting solutions, make effective decisions, and take corrective action.
Strong organizational skills and ability to maintain clear, complete records of activities, cases, and related documentation.
Knowledge and skill in using the MS Office suite and pharmacy applications.

Responsibilities

Review patient files for completeness and accuracy, identify all revenue opportunities, and complete and submit prior authorizations promptly for payer reimbursement.
Communicate authorization status effectively with franchise partners, payers, and other VCI departments.
Document case activity, communications, correspondence, and actions taken to resolve authorization issues in the computer system; schedule follow-ups at required intervals.
Investigate and verify benefits for pharmacy and medical third-party claims.
Obtain reauthorizations by initiating requests, following up with required information, tracking progress, expediting payer responses, and keeping customers informed.
Track, report, and escalate service issues related to authorization requests or other issues that may delay service, supporting patient access and avoiding interruptions to therapy.
Communicate patients’ financial obligations so they understand therapy costs before beginning service.
Perform other related duties as assigned.

Benefits

Medical, dental, and vision plans
Flexible spending accounts and health savings accounts
Paid time off, personal days, and company-paid holidays
Paid paternal leave
Volunteerism days off
Company-sponsored basic life insurance and long-term disability insurance
Employee-paid voluntary life, accident, critical illness, and short-term disability insurance
401(k) matching
Tuition reimbursement
Employee assistance programs for mental health, financial, and legal support
Rewards programs offered by the medical carrier
Professional development and growth opportunities
Employee referral program