Cvs Health Prior Authorization Remote Jobs in Tennessee

Join IVX Health as a Prior Authorization Coordinator!

Join a team that's redefining infusion care and creating exceptional patient experiences.

Are you experienced in navigating the complexities of prior authorizations for biologics or oncology therapies? IVX Health is looking for a driven and detail-oriented Prior Authorization Coordinator to support our rapidly growing team. In this role, you'll have the opportunity to make a meaningful impact by facilitating the approval process for life-changing specialty treatments. Our HQ is based just outside of Nashville in Brentwood, TN, but we are seeking candidates nationwide with the option to work fully remote, hybrid, or in-office!

Location and Schedule at a Glance

• Work Options: Fully Remote, Hybrid, or In-office (Brentwood, TN)
• Schedule: Monday - Friday, standard business hours (no nights, weekends, or holidays)

What You Will Do

• Review and Process Prior Authorizations – Thoroughly review Prior Authorization orders and ensure timely and accurate completion.
• Manage Clinical Documentation – Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions.
• Submit and Track Prior Authorizations – Follow criteria for medication approvals and accurately submit requests to insurance providers.
• Resolve Authorization Issues – Investigate and resolve outstanding medical documentation concerns and assist in resolving denied claims.
• Support Patients and Providers – Communicate effectively with patients, clinical staff, and insurance representatives regarding the Prior Authorization process.
• Ensure Compliance and Process Improvement – Stay up to date with evolving payer policies and identify ways to enhance workflow efficiency.
• Perform Additional Duties – Take on other responsibilities as assigned to support patient care and operational objectives.

What We Are Looking For

We are seeking ambitious, self-motivated, and reliable professionals who take ownership of their work and excel in both remote and office settings. Success in this role requires initiative, accountability, and a commitment to getting the job done.

If you thrive in a structured yet independent work environment, communicate effectively, and hold yourself accountable, you will excel here. We value high performers who are dependable, communicative, and committed to delivering results.

• Prior Authorization Expertise is Essential – You must have hands-on experience with prior authorizations for biologics, oncology, or specialty therapies, along with a strong understanding of payer guidelines.
• Exceptional Communication Skills – This role involves frequent interaction with clinical teams, insurance companies, and patients. You must be able to communicate clearly, professionally, and persistently follow up when needed.
• Self-Motivated and Accountable – If you work remotely, you are expected to be present, engaged, and consistently perform at a high level without direct supervision.
• Tech-Savvy and Detail-Oriented – Proficiency in Electronic Health Records (EHR) systems, payer portals, and Microsoft Office Suite is required.
• High School Diploma or GED required.
• Associate's degree in Medical Office Management, Medical Insurance, or Medical Coding is a plus.
• Minimum of three (3) years of experience in hospital or clinical service access, physician office scheduling, or a similar role.
• Certified Medical Assistant (CMA) is a plus.
• Experience with prior authorizations for biologics, oncology, or specialty therapies preferred.

Why Join IVX Health

• Make a Meaningful Impact – Play a critical role in securing approvals for life-changing specialty treatments that directly improve patients' lives.
• Grow Your Career – IVX Health offers a clear career path for Prior Authorization Coordinators, with opportunities for promotion from Level 1 to Level 2 and Level 3 based on performance and expertise..
• Be Part of a Supportive and High-Performing Team – Work alongside a motivated, goal-driven team that values accountability, integrity, and results while fostering a positive, patient-focused environment.
• Support and Development – Gain access to continuing education, professional development resources, and mentorship opportunities to expand your expertise.
• Work-Life Balance – Enjoy flexible work options (remote, hybrid, or in-office), paid time off, and a no nights, no weekends schedule so you can recharge and perform at your best.