Intake & Authorization Specialist

100% Remote Please Apply Only If You Have 3+ Years of Intake, Benefits Verification, and Prior Authorization Experience Join AIS Healthcare 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. Why Join AIS Healthcare? We offer a comprehensive benefits package, including: 100% Remote Work OpportunityMedical, Dental, and Vision InsuranceCompany-Paid Life InsuranceLong-Term Disability InsuranceGenerous Paid Time Off401(k) with Generous Employer MatchCareer Growth OpportunitiesSupportive and Collaborative Team Environment Position Summary 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. What You'll Do Receive, review, and process patient referrals from providers, hospitals, and referral sourcesVerify patient insurance eligibility and benefitsDetermine authorization requirements and obtain approvals from insurance carriersManage authorizations, referrals, pre-determinations, and reauthorizationsResearch insurance coverage and patient financial responsibilityReview referral documentation for completeness and accuracyFollow up on missing clinical documentation, physician orders, and authorization requirementsInitiate and manage appeals for denied authorizations when appropriateCommunicate with patients regarding coverage, benefits, and financial responsibilityCoordinate with nurses, pharmacists, providers, case managers, and referral sources to facilitate the start of careMaintain detailed documentation and account notes within company systemsMonitor and follow up on pending authorizations and referrals until resolvedEnsure compliance with HIPAA, payer requirements, and company policiesMaintain knowledge of insurance plans, medical terminology, payer guidelines, and authorization processesSupport team members by sharing knowledge and best practices Required Qualifications High School Diploma or GEDMinimum of 3 years of Intake, Benefit Verification, and/or Prior Authorization experience3–5 years of healthcare industry experience preferredStrong understanding of commercial and government insurance plansExperience obtaining and managing prior authorizationsKnowledge of insurance verification and benefits investigation processesStrong attention to detail and organizational skillsAbility to manage multiple priorities and deadlinesExcellent written and verbal communication skillsAbility to work independently in a remote environmentProficiency in Microsoft Outlook, Word, and Excel Preferred Qualifications Home Infusion experienceSpecialty Pharmacy experienceIntrathecal Pain Management experienceExperience with medical and pharmacy benefit authorizationsExperience with appeals and denial managementFamiliarity with payer portals and insurance verification systemsKnowledge of infusion therapies and specialty medications How to Apply To be considered for this position, you must complete the Culture Index Assessment. Culture Index Assessment: http://portal.cultureindex.com/public/survey/general/0BFB8F0000 Important: Applications will not be reviewed until the assessment has been completed. If the assessment link does not open when clicked, please copy and paste the URL directly into your browser. If you continue to experience issues, try using a different browser. About AIS Healthcare 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. AIS Healthcare | Advancing Quality. Improving Lives.