Job Overview We are seeking a highly organized, detail-oriented, and dependable Verification and Authorization Specialist to manage the end-to-end authorization process for infusion therapy orders. This role is central to ensuring accurate, timely, and compliant onboarding of patients—particularly in securing insurance approval for high-cost medications. The ideal candidate will have strong communication skills, a high degree of accountability, and the ability to collaborate cross-functionally in a fast-paced healthcare setting.

Note:

This position will also need to be available to cover the Front Office Coordinators' basic duties on site in either Dyer or Hobart locations for sick and PTO coverage. This will be scheduled and unscheduled based on need. Duties Review and process all new infusion orders and referrals for completeness and compliance. Accurately verify insurance eligibility and medical benefits, including drug coverage and site-of-care requirements. Obtain prior authorizations from insurance carriers for all ordered infusion medications and services. Coordinate benefit investigation and secure appropriate documentation from payers, providers, and patients. Manage communication with referring providers regarding missing documentation or order clarifications. Track and document all steps in the intake and authorization process in the EMR system. Collaborate with the clinical, revenue cycle, and front office teams to ensure smooth and timely patient onboarding. Maintain proactive communication with patients regarding their status, responsibilities, and appointment details. Escalate urgent or complex authorization issues to leadership or payers to avoid treatment delays. Work closely with pharmaceutical hubs and patient assistance programs as needed. Requirements Previous experience in a medical office or dental office setting is preferred. Strong knowledge of managed care processes and medical terminology. Familiarity with CPT coding, ICD coding (ICD-9 and ICD-10), and medical records management. Excellent organizational skills with attention to detail. Ability to communicate effectively with diverse groups including healthcare professionals and patients. Proficient in using office software and electronic health record systems. A commitment to maintaining confidentiality in accordance with HIPAA guidelines. If you are passionate about healthcare administration and possess the necessary skills, we encourage you to apply for this vital role within our organization. Ensure that all intake documentation, payer approvals, and communication logs are complete, accurate, and audit-ready. Monitor medication-specific requirements including diagnosis codes, lab results, and step therapy history. Protect patient confidentiality in compliance with HIPAA and company policies. Identify and recommend improvements to reduce turnaround time and prevent authorization denials. Stay informed on payer policy changes, specialty drug requirements, and infusion industry best practices.

Qualifications:

High school diploma or equivalent required; associate or bachelor's degree in healthcare administration or related field preferred. Minimum of 3 years of experience in a medical intake, insurance verification, or prior authorization role— infusion or specialty pharmacy experience strongly preferred . Deep knowledge of commercial, Medicare, and Medicaid payer guidelines and benefit structures. Familiarity with EMRs, payer portals, and specialty pharmacy workflows. Exceptional attention to detail, with a commitment to accuracy and error prevention. Strong organizational and time management skills with the ability to handle multiple authorizations concurrently. Excellent written and verbal communication skills; professional phone and email etiquette. Ability to work independently and collaboratively under deadline-driven conditions. HIPAA Compliance All employees are required to maintain the confidentiality, integrity, and security of all patient information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and all applicable state and federal privacy regulations.

This includes:

Accessing, using, and disclosing Protected Health Information (PHI) only as necessary to perform assigned job duties. Safeguarding all patient data—verbal, written, or electronic—against unauthorized access, disclosure, or misuse. Completing annual HIPAA training and demonstrating understanding of company privacy and security policies. Reporting any suspected breaches of PHI or HIPAA violations immediately to the appropriate compliance officer or supervisor. Participating in audits and compliance initiatives as directed by leadership or regulatory agencies. Failure to comply with HIPAA policies may result in disciplinary action, up to and including termination of employment.

Job Type:

Full-time Pay:

$18.00 - $23.00 per hour

Work Location:

In person