Authorization Specialist

Vital Care Infusion Services•Phoenix, AZ

10d

About The Position

The Authorization Specialist initiates and manages authorizations with a focus on accuracy, timeliness, and adherence to processes that help reduce denials, 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 specialist reviews patient files, verifies benefits, obtains authorizations and reauthorizations, follows up with payers, documents account activity, and keeps franchise partners, customers, and internal departments informed. The role also communicates patients’ financial obligations before therapy begins and escalates issues that may delay service or interrupt therapy.

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, and the ability to communicate with patients, caregivers, and payer representatives while advancing reimbursement and collection efforts.
Understanding of processes, systems, and techniques for 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 the 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 revenue opportunities, and submit prior authorizations in a timely manner for payer reimbursement.
Communicate authorization status with franchise partners, payers, and other Vital Care Infusion Services 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 delay service, helping maintain patient access and prevent interruptions to therapy.
Communicate financial obligation information to patients 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