Authorization Specialist - Revenue cycle Management

Vital Care Infusion Services•Dallas, TX

About The Position

The Authorization Specialist performs duties to initiate authorizations, with a focus 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 for credentialing and re-credentialing, and contract applications. The position supports patient access to infusion therapy by coordinating authorization requests, communicating financial obligations, and addressing issues that could delay service.

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, 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 track and 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 revenue opportunities, and complete and submit prior authorizations promptly for payer reimbursement.
Communicate authorization status effectively with franchise partners, payers, and other Vital Care departments.
Document case activity, communications, and correspondence in the computer system to maintain complete and accurate account records and record actions taken to resolve outstanding authorization issues.
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 additional information, tracking progress, expediting responses from insurance carriers and other payers, and keeping customers informed.
Track, report, and escalate service issues arising from authorization requests or other issues that delay service, supporting patient access and avoiding interruptions to therapy.
Communicate patients’ financial obligations so they understand therapy costs before starting service.
Perform other related duties as assigned.

Benefits

Comprehensive medical, dental, and vision plans
Flexible spending 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