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Infusion Prior Authorization Jobs in Alabama (NOW HIRING)

Alabama Oncology

Clinical Pharmacist

Birmingham, AL

$111K - $132K/yr

... Infusion Services Employment Type Full-Time Location Grandview Medical Center - Oncology Position ... Collaborate with financial counseling and prior authorization teams regarding specialty medications ...

Alabama Oncology

Clinical Pharmacist

Birmingham, AL · On-site

$111K - $132K/yr

... Infusion Services Employment Type Full-Time Location Grandview Medical Center - Oncology Position ... Collaborate with financial counseling and prior authorization teams regarding specialty medications ...

Alabama Oncology

Clinical Pharmacist

Birmingham, AL · On-site

$111K - $132K/yr

... Infusion Services Employment Type Full-Time Location Grandview Medical Center - Oncology Position ... prior authorization teams regarding specialty medications and payer requirements. • Partner with ...

Alabama Oncology

Clinical Pharmacist

Birmingham, AL · On-site

$111K - $132K/yr

... Infusion Services Employment Type Full-Time Location Grandview Medical Center - Oncology Position ... prior authorization teams regarding specialty medications and payer requirements. • Partner with ...

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Infusion Prior Authorization information

What is an infusion prior authorization specialist?

An Infusion Prior Authorization specialist is a healthcare professional responsible for obtaining approval from insurance companies for patients to receive infusion therapies. They review medical records, collaborate with providers, and ensure all necessary documentation is submitted to meet insurance requirements. Their work helps patients access important treatments while minimizing delays and out-of-pocket costs. They also communicate with both patients and insurance representatives to resolve any issues related to coverage or denials.

What are the typical challenges faced in an infusion prior authorization role, and how can they be managed?

Professionals in Infusion Prior Authorization often encounter challenges such as navigating complex insurance requirements, managing high volumes of requests, and ensuring timely approvals to prevent delays in patient care. Staying organized, maintaining clear communication with providers and payers, and keeping up-to-date on changing insurance policies can help address these challenges. Additionally, close collaboration with clinical teams and ongoing training in authorization systems are key to efficiently managing the workload and supporting positive patient outcomes.

What are the key skills and qualifications needed to thrive as an infusion prior authorization specialist, and why are they important?

To excel as an Infusion Prior Authorization Specialist, you need a thorough understanding of medical terminology, insurance policies, and healthcare regulations, often supported by a background in healthcare administration or billing. Familiarity with prior authorization software, electronic health records (EHR), and payer portals is typically required. Strong attention to detail, organizational skills, and effective communication are essential soft skills for navigating complex documentation and coordinating with providers and insurers. These competencies ensure timely approvals, reduce delays in patient care, and help healthcare organizations maintain compliance and reimbursement efficiency.

What is the difference between Infusion Prior Authorization vs Pharmacist?

AspectInfusion Prior AuthorizationPharmacist
CredentialsTypically requires healthcare licensing, certification in infusion therapyRequires pharmacy degree, licensure, and certification
Work EnvironmentHospitals, clinics, infusion centersPharmacies, hospitals, healthcare facilities
Industry UsageInsurance approval process for infusion treatmentsMedication dispensing, patient counseling, medication management

Infusion Prior Authorization involves obtaining insurance approval for infusion therapies, focusing on approval processes. Pharmacists dispense medications and provide patient counseling. While both roles require healthcare credentials, infusion prior authorization specialists focus on insurance and approval procedures, whereas pharmacists handle medication management and dispensing.

How do I become an infusion prior authorization specialist?

To become an infusion prior authorization specialist, candidates typically need a high school diploma or equivalent, along with knowledge of medical billing, insurance processes, and prior authorization procedures. Relevant skills include attention to detail, communication, and familiarity with electronic health record (EHR) systems; some roles may require certification in medical billing or coding. On-the-job training is common, and experience in healthcare or insurance can improve job prospects.

Is infusion prior authorization a stressful job?

Infusion prior authorization is a role that involves reviewing medical documentation and coordinating with healthcare providers to approve infusion treatments. The job can be stressful due to tight deadlines, high accuracy requirements, and the need to manage complex insurance policies. Strong organizational skills and attention to detail are important to succeed in this position.

What are popular job titles related to Infusion Prior Authorization jobs in Alabama?

For Infusion Prior Authorization jobs in Alabama, the most frequently searched job titles are:

What job categories do people searching Infusion Prior Authorization jobs in Alabama look for?

The top searched job categories for Infusion Prior Authorization jobs in Alabama are:

What cities in Alabama are hiring for Infusion Prior Authorization jobs?

Cities in Alabama with the most Infusion Prior Authorization job openings:

Infusion Prior Authorization jobs near you
Infographic showing various Infusion Prior Authorization job openings in Alabama as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Clinical Documentation Specialist Outpatient

Birmingham, AL • On-site

Children's of Alabama
Health Care and Social Assistance • 5 - 10K employees

6.1

Company rating: 6.1 out of 10

Based on 42 frontline employees who took The Breakroom Quiz

849th of 1,064 rated hospitals

Great coworkers

People enjoy working here

Recommended by parents

Learn more about Children's of Alabamaexternal

$32.50 - $43.75/hr

Full-time

Re-posted 15 hours ago

Job description

In Clinical Documentation Integrity at Main Campus Lee Building
Work schedule will be Full-time on the Day Shift, Monday-Friday.
Summary:
The Outpatient Clinical Documentation Integrity (CDI) Specialist Nurse will provide clinically based reviews of outpatient medical records to assess and procure accurate, complete, and compliant documentation of the patients' visit encounter. The goal is to facilitate clinically appropriate physician and other clinician documentation of all patient conditions, treatments, and interventions to accurately reflect quality of care, severity of illness, risk of morality and risk adjustment factor to support correct coding, reimbursement, and quality initiatives. The goal of CDI outpatient reviews is to facilitate clinically appropriate physician/ clinician documentation of all patient conditions, treatments, and interventions to accurately reflect quality of care, severity of illness and risk of morality and risk adjustment factor to support correct coding, reimbursement, and quality initiatives. This role will work closely with all levels of leadership, subject matter experts, and operational stakeholders to remain compliant with state and federal regulatory codes and guidelines.
Other information:
Minimum Requirements
• Registered Nurse (RN) preferred
• Current RN or LPN Licensure in the State of Alabama required
Experience
• At least five years of nursing experience required (3 of these years must be in acute or intensive care setting), prefer pediatric experience. Will consider CDI experience in lieu of pediatric experience.
Licensures, Certifications, and/or Registries
• CCDS and/or Coding certification (ex. CPC) highly desired or willingness to complete after employment.
Credentials with Equivalent Qualifications:
Essential:
* Registered Nurse AL Single State or any of the following equivalent qualifications below:
- Registered Nurse AL NLC Multi State
- Registered Nurse Non-AL NLC Multi State
Nonessential:
* Certified Coding Specialist or Certified Coding Associate
Education with Equivalent Qualifications:
Essential:
* Bachelor of Science Nursing in Nursing or Associate of Science Nursing in Nursing
Experience with Equivalent Qualifications:
Essential:
* 5 Years job experience as Staff Level with specialization in the field of Nursing Acute
The Clinical Documentation Integrity (CDI) department plays a key role within the Revenue Cycle by ensuring the accuracy and integrity of clinical documentation and related processes. The department encompasses several specialized areas: Inpatient and Outpatient CDI, Infusion Prior Authorizations, Medical Audit, and Medicaid Screening. Each area is staffed by experienced nurses who review medical records for various clinical and regulatory purposes. Inpatient and Outpatient CDI Nurses conduct concurrent and retrospective reviews of medical records to ensure documentation accurately reflects the patient's clinical status, severity of illness, and treatments. Their work supports appropriate coding, reimbursement, and compliance, while also providing ongoing documentation education to physicians and clinical staff. Infusion Prior Authorization Nurses manage prior authorization requests for outpatient infusions, including those requiring peer-to-peer reviews or appeals. They collaborate closely with Billing on denials and appeals to support timely patient care and reimbursement. Medical Audit Nurses perform chart audits to ensure hospital charges are appropriate and compliant. They identify billing trends, correct discrepancies, and support hospital departments with charge integrity. Medicaid Screening Nurses focus on EPSDT and Interperiodic Screenings for patients with Medicaid coverage. Their detailed reviews ensure compliance with state and federal Medicaid regulations. Together, these teams support clinical excellence, regulatory compliance, and financial sustainability through comprehensive documentation and review processes.
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About Children's of Alabama

Sourced by ZipRecruiter

Since 1911, Children’s of Alabama has provided specialized medical care for ill and injured children. Ranked among the best children’s hospitals in the nation by U.S. News & World Report, Children’s serves patients from every county in Alabama and nearly every state. With more than 3.5 million square feet, it is one of the largest pediatric medical facilities in the United States. Children’s offers inpatient and outpatient services at its Russell Campus on Birmingham’s historic Southside with additional specialty services provided at Children’s South, Children’s on 3rd and in Huntsville and Montgomery. Primary medical care is provided in more than a dozen communities across central Alabama. Children’s is the only health system in Alabama dedicated solely to the care and treatment of children. It is a private, not-for-profit medical center that serves as the teaching hospital for the University of Alabama at Birmingham (UAB) pediatric medicine, surgery, psychiatry, research and residency programs. The medical staff consists of UAB faculty and Children’s full-time physicians as well as private practicing community physicians. Our staff is committed to providing the finest pediatric healthcare to all children. We built our legacy on our core values of trust, teamwork, compassion, innovation and commitment. We know that every time we come through these doors we will live up to our high standards as we work to make a difference in children's lives. You've chosen a career that’s all about care. If you want to make a difference the life of children and their families, if you want to advance in your profession, if you appreciate good benefits, and want to work with outstanding medical professionals in a variety of areas, then Children’s of Alabama is where you belong.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Birmingham, AL, US

Year founded

1911

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