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Infusion Prior Authorization Jobs in Virginia (NOW HIRING)

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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 Virginia?

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

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

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

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

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

Infusion Prior Authorization jobs near you
Infographic showing various Infusion Prior Authorization job openings in Virginia as of August 2026, with employment types broken down into 92% Full Time, and 8% Part Time. Highlights an 92% In-person, and 8% Remote job distribution.

Specialty Pharmacy Technician - as needed

Riverside

Newport News, VA

$23.90 - $31.10/hr

Part-time

Re-posted 16 days ago

Job description

Newport News, Virginia

Hiring Range

$23.90 - $31.10/Hourly Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.


Overview
Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist, while serving as a liaison between patients, providers, payers, and manufacturers to facilitate timely medication approval and therapy initiation. Ensures accurate documentation, clear communication, and compliance with specialty pharmacy accreditation standards and all applicable state and federal regulations while supporting a positive patient experience.
What you will do

  • Timely process of referrals and submit clinical supporting documentation to insurance carriers, manufacturers, or foundations to expedite prior authorization and/or patient assistance processes. Collaborate with other departments to assist in obtaining prior authorizations, patient assistance medications or financial assistance. Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed. Follows prior authorization and/or patient assistance workflows and policies/procedures.
  • Demonstrates the ability to work independently, meet deadlines and possesses excellent time management skills. Perform tasks accurately and efficiently. Possesses excellent interpersonal, customer service and communication skills (both written and verbal); timely responses to key stakeholders.
  • Accurate documentation of all intake referrals and/or prior authorization information in patient medical record or patient assistance tracking software in compliance with policy and procedure/workflow. Completes timely documentation within the required tracking systems and retrieves necessary documentation and maintains up to date knowledge of the pharmaceutical companies' patient assistance programs.
  • Proactively tracks and manages patient refills/outreach to ensure timely prescription/infusion service.
  • Proactively works on prior authorization and patient assistance enrollments that are due to expire.
  • Secure patients' demographic and medical information in compliance with organization HIPAA policies and procedures.
  • Assists management with inspections, audits, reports and training to ensure compliance with standards and to provide quality service.


Qualifications
Education

  • Program Graduate, Pharmacy Technician Training Program or equivalent (Preferred) or
  • Program Graduate, Licensed Practical Nurse (Required) or
  • Program Graduate, Certified Medical Assistant (Required)


Experience

  • 3-4 years Experience as a Pharmacy Technician, LPN or CMA (in lieu of education) (Required)
  • 1 year Experience obtaining and managing medication prior authorization as part of job function (Preferred)
  • 1 year Prior Experience obtaining and managing patient assistance program applications (Preferred)


Skills and Abilities

  • Familiar with medical and pharmacy terminology
  • Prescription drug and over-the-counter knowledge
  • Basic math skills, including pharmaceutical calculations
  • Basic pharmacy workflow
  • Understanding pharmacy computer systems
  • Ability to navigate and read electronic health record
  • Strong written and verbal communication skills
  • Ability to prioritize, problem solve and multitask
  • Excellent customer service skills
  • Knowledge of patient assistance programs
  • Experience with prior authorization of medications
  • Strong organizational skills and detail oriented


Licenses and Certifications

  • Registered Pharmacy Technician - Virginia Department of Health Professions (VDHP) Upon Hire(Required) and
  • Pharmacy Technician Certification Board (PTCB) - Pharmacy Technician Certification Board (PTCB) PTCB or ExCPT Upon Hire(Required) or
  • Licensed Practical Nurse (LPN) - Virginia Department of Health Professions (VDHP) Upon Hire(Required) or
  • Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) Upon Hire(Required)
  • Advanced certification in specialty pharmacy field (PTCB, ASHP, NCODA and other approved programs) (Preferred)

To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.

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