Experienced Intake / Authorization Specialist

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Infusion Care solutions. Guided by our core values of Innovation, Stewardship, and Unity, we are committed to Advancing Quality and Improving Lives for the patients, providers, and communities we serve.

We are seeking an experienced Intake & Authorization Specialist to join our growing team. This role is ideal for a healthcare professional who enjoys managing referrals, verifying insurance benefits, obtaining authorizations, solving insurance-related issues, and helping patients gain access to the therapies they need.

If you're looking for a remote opportunity with a company that values teamwork, accountability, patient care, and professional growth, we'd love to hear from you.

The Intake & Authorization Specialist is responsible for managing patient referrals, verifying insurance benefits, obtaining authorizations, and coordinating patient onboarding activities for infusion and targeted drug delivery services.

The ideal candidate will have strong knowledge of insurance verification, medical and pharmacy benefits, authorization requirements, payer guidelines, and patient financial responsibility. This individual must be detail-oriented, highly organized, and capable of working independently while managing multiple referrals and deadlines.

• →Receive, review, and process patient referrals from providers, hospitals, and referral sources
• →Verify patient insurance eligibility and benefits
• →Determine authorization requirements and obtain approvals from insurance carriers
• →Manage authorizations, referrals, pre-determinations, and reauthorizations
• →Research insurance coverage and patient financial responsibility
• →Review referral documentation for completeness and accuracy
• →Follow up on missing clinical documentation, physician orders, and authorization requirements
• →Initiate and manage appeals for denied authorizations when appropriate
• →Communicate with patients regarding coverage, benefits, and financial responsibility
• →Coordinate with nurses, pharmacists, providers, case managers, and referral sources to facilitate the start of care
• →Maintain detailed documentation and account notes within company systems
• →Monitor and follow up on pending authorizations and referrals until resolved
• →Ensure compliance with HIPAA, payer requirements, and company policies
• →Maintain knowledge of insurance plans, medical terminology, payer guidelines, and authorization processes
• →Support team members by sharing knowledge and best practices

• High School Diploma or GED
• Minimum of 3 years of Intake, Benefit Verification, and/or Prior Authorization experience
• 3–5 years of healthcare industry experience preferred
• Strong understanding of commercial and government insurance plans
• Experience obtaining and managing prior authorizations
• Knowledge of insurance verification and benefits investigation processes
• Strong attention to detail and organizational skills
• Ability to manage multiple priorities and deadlines
• Excellent written and verbal communication skills
• Ability to work independently in a remote environment
• Proficiency in Microsoft Outlook, Word, and Excel

• Home Infusion experience
• Specialty Pharmacy experience
• Intrathecal Pain Management experience
• Experience with medical and pharmacy benefit authorizations
• Experience with appeals and denial management
• Familiarity with payer portals and insurance verification systems
• Knowledge of infusion therapies and specialty medications

To be considered for this position, you must complete the Culture Index Assessment.

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Important: Applications will not be reviewed until the assessment has been completed.

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AIS Healthcare is the nation's leading provider of advanced sterile, patient-specific intrathecal pump medications and in-home infusion therapies. Through innovative pharmacy services, specialized nursing support, and comprehensive care coordination, we help providers deliver exceptional patient care and outcomes.

We're looking for positive, hardworking professionals who are passionate about making a difference in the lives of patients and providers.