Prior Authorization Specialist

Aleracare Phoenix, Arizona, United States

Pure Infusion is a fast-growing healthcare company and a leader in chronic-condition infusion therapy. We deliver a personalized, private, and meaningful infusion experience for patients who often need ongoing care and consistency. Pure Infusion has been recognized as one of Utah's fastest-growing companies, and we believe that growth is a reflection of our people, purpose, values, and patient-first culture.

Our patients are referred by specialty physicians for biologic and other infusion therapies, often related to autoimmune disorders or primary deficiencies. These patients need more than an appointment. They need a place that feels calm, professional, comfortable, and human.

We care deeply about patients, teammates, referring providers, and every person who interacts with Pure Infusion.

We look for ways to make every visit, every process, and every interaction better than it was yesterday.

We are willing to challenge old healthcare assumptions and build a better model for patients and teams.

We serve with humility, appreciate the people around us, and believe gratitude should turn into action.

Our regular hours are generally Monday through Friday, 8 a.m. to 5 p.m., with most weekends and holidays off. In addition to a competitive hourly rate, we offer:

• Competitive hourly rate
• 401(k) Matching
• Health, Vision, and Dental Insurance
• Over 20 days of paid time off annually
• One paid community service day each year to give back in a way that matters to you, either with your clinic, with the corporate team, or through a community cause you personally care about

Behind every approved infusion treatment is a Prior Authorization Specialist who navigated payer policy, step therapy requirements, and paperwork so the patient never had to. We're looking for someone who thrives on solving that puzzle quickly and accurately.

This isn't a repetitive data-entry job. Every case is its own investigation, requiring you to interpret clinical documentation, understand payer policy, and figure out exactly what it will take to get a patient's treatment approved.

You’ll manage a real caseload of active authorizations, work across systems like Salesforce, WeInfuse, and AMD, and collaborate daily with providers, clinical teams, and internal stakeholders to keep cases moving. The work you do directly determines how quickly patients get the treatment they need.

If you like being the person who cracks the case and gets things unstuck, this role gives you that challenge every day.

The Prior Authorization Specialist is a vital team member responsible for efficiently managing the prior authorization process to ensure seamless patient care and timely treatment. This role requires a solid understanding of medical benefits, step therapy, and authorization policies, along with exceptional organizational, communication, and problem-solving skills.

You will manage a caseload of at least 30 active authorizations and skillfully navigate systems such as Salesforce, WeInfuse, and AMD to track and update case progress, send communications, and meet critical deadlines. This role is key to maintaining operational efficiency and directly contributes to Pure Infusion's standard of excellence and patient satisfaction.

• -Process prior authorizations accurately and efficiently, including reviewing step therapy, minimum authorization requirements, and payer-preferred medications.
• -Manage appeals and denials, escalating cases when necessary, and follow appropriate payer protocols.
• -Analyze insurance policies for each case and communicate with internal teams or providers to obtain needed documentation when a case does not align with policy.
• -Verify insurance benefits and determine in-network (INN) or out-of-network (OON) status across various payers and states under Intake standards.
• -Evaluate medical and pharmacy benefits to determine patient eligibility for treatment.
• -Maintain clear, professional communication with providers, patients, internal teams, and stakeholders.
• -Accurately document all case-related conversations and updates within Salesforce within required time frames.
• -Prioritize personal tasks and authorizations to ensure timely completion and follow-up.
• -Collaborate with internal team members,…