Infusion Authorization & Billing Specialist

Iowa Digestive Disease Center•Clive, IA

About The Position

The Infusion Authorization & Billing Specialist supports infusion services by managing pre-authorizations, charge entry, reporting, and the complete revenue cycle from authorization through claim resolution, in accordance with payer and regulatory requirements. This role plays a critical part in ensuring accurate billing, regulatory compliance, timely reimbursement, and a positive patient financial experience while supporting clinical operations.

Requirements

High school diploma required
Minimum of one year of healthcare or medical office experience preferred
Working knowledge of medical terminology, insurance processes, and revenue cycle workflows
Proficiency with electronic medical records (EMR), billing systems, and claims management software
Strong computer skills, including Excel and other Microsoft Office applications
Accurate typing and data entry skills, including ten-key
Strong written and verbal communication skills
Ability to work independently, prioritize tasks, and meet deadlines
High attention to detail and accuracy
Effective problem-solving and critical-thinking abilities
Ability to adapt in a fast-paced, regulated healthcare environment
Demonstrated commitment to compliance, accountability, and ethical standards
Professional, tactful, and patient-focused demeanor
Organized, flexible, and able to function effectively under pressure
Receptive to feedback and committed to continuous improvement
Demonstrates initiative and ownership of responsibilities
Respects and supports diversity, equity, and inclusion
Actively supports the mission, values, and philosophy of the organization

Nice To Haves

Coding Certification and/or Certified Medical Assistant (CMA) preferred

Responsibilities

Enter, review, and maintain accurate charge data in accordance with current CPT, HCPCS, and payer-specific coding guidelines
Post payments, adjustments, and account notes accurately within billing and medical record systems
Generate and analyze departmental reports to support operational and financial performance
Collaborate with coding, billing, and clinical teams to resolve discrepancies and ensure clean claims
Identify and correct charge or posting errors in a timely and compliant manner
Obtain and track required pre-authorizations for biologic medication services
Verify insurance coverage and eligibility on a daily basis
Monitor patient schedules to ensure authorizations, documentation, and required testing are complete
Communicate authorization approvals, denials, and delays clearly within electronic medical records and billing systems
Initiate and manage authorization appeals in accordance with payer and regulatory requirements
Support scheduling coordination and proactively address authorization-related barriers to care
Ensure all activities comply with HIPAA, CMS regulations, payer policies, and organizational standards
Maintain strict confidentiality of patient and organizational information
Support audits, quality initiatives, and continuous process improvement efforts
Apply sound judgment and problem-solving skills to resolve issues and prevent recurrence
Provide professional, respectful, and patient-centered communication at all times
Handle sensitive or complex patient financial conversations with empathy and clarity
Promote teamwork, collaboration, and a positive work environment across departments