Prior Authorization Coordinator

. Maintain prior authorizations, copay assistance, and verify existing insurance coverage for ongoing services .

Posted 9/25/2026full-timeRemote • United StatesJuniorMid-Level💰 $20 - $23 per hourWebsite

Key responsibilities & impact

Maintain prior authorizations, copay assistance, and verify existing insurance coverage for ongoing services
Obtain detailed insurance benefit information and maximize plan benefits
Verify insurance benefit information monthly using online tools, calls to payors, and test claims
Generate prior authorization expiration reports weekly, bi-weekly, or monthly
Review clinical documents for prior authorization and pre-determination submissions
Secure prior authorization, pre-determination, or medical review
Contact prescribers’ offices to obtain information for re-authorization and benefits verification
Make outbound calls to patients or prescribers’ offices regarding processing delays and missing information
Document insurance coverage of medications, administration supplies, and related infusion services
Provide timely and accurate customer service to internal and external customers
Notify patients about financial responsibility, benefit coverage, and payor authorization
Generate patient forms
Maintain current prior authorization reports

What you’ll need

Must have at least 2 years of home infusion specialty pharmacy experience, including prior authorizations, running test claims, and HCPC calculations
Specialty home infusion experience required
2 years of prior authorization experience required
High school diploma or equivalent required
Previous medical and pharmacy benefit experience is required
Initiating and securing prior authorizations, pre-determination, and appeals
Ability to interpret payor contract fee schedules based on NDC and HCPCS units
Ability to effectively handle multiple priorities within a changing environment
Monday-Friday availability, 9:30am-6:00pm Central Standard Time

Comp & perks