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Infusion Prior Authorization Jobs (NOW HIRING)

Summit Medical Center

Infusion Nurse - PRN

Casper, WY · On-site

$35.75 - $47.50/hr

Prior Authorizations & Care Coordination * Complete, submit, and track prior authorizations for infusion medications, imaging, labs, or associated treatments. * Coordinate with insurance companies ...

Soleo Health, Inc.

Clearance Specialist - Remote

$23 - $27/hr

Must have experience with Acute Infusion for Prior authorization/Benefits Verification Requirements * High school diploma or equivalent * At least 2 years of home infusion specialty pharmacy and/or ...

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Infusion Prior Authorization information

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$11

$45

$82

How much do infusion prior authorization jobs pay per hour?

As of Jul 12, 2026, the average hourly pay for infusion prior authorization in the United States is $45.96, according to ZipRecruiter salary data. Most workers in this role earn between $36.30 and $50.24 per hour, depending on experience, location, and employer.

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.

Is being a prior authorization specialist hard?

Being a prior authorization specialist can be challenging due to the need for attention to detail, understanding insurance policies, and managing multiple cases efficiently. The role often requires strong communication skills, familiarity with medical billing systems, and the ability to handle repetitive tasks under deadlines.

Is there a demand for infusion nurses?

Infusion nurses are in high demand due to the increasing need for intravenous therapies in hospitals, clinics, and home care settings. The role requires specialized skills, certifications, and knowledge of infusion techniques, and employment opportunities are expected to grow as healthcare services expand and aging populations require more complex treatments.

What is infusion prior authorization?

Infusion prior authorization is a process where healthcare providers submit documentation to insurance companies to obtain approval for infusion therapy treatments before administering them. This step ensures coverage and helps prevent claim denials, often requiring knowledge of insurance policies and medical necessity criteria. The role may involve reviewing patient records, coordinating with providers, and ensuring compliance with payer requirements.

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.

How to become a prior authorization specialist?

To become a prior authorization specialist, candidates typically need a high school diploma or equivalent, along with experience in healthcare or insurance billing. Relevant skills include knowledge of medical terminology, insurance policies, and authorization processes, often supported by certifications such as the Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS).

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.
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Infusion Prior Authorization jobs near you
Infographic showing various Infusion Prior Authorization job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 88% Full Time, 10% Part Time, and 1% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $95,606 per year, or $46 per hour.

Network Prior Authorization and Referral Specialist

St. Luke's Health Network, Inc.

Allentown, PA • On-site

$17.75 - $23.75/hr

Other

Posted 10 days ago

Job description

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. Responsible for accurate and timely pre-registration, submission of prior authorizations for SLPG Primary Care and Specialty practices, submission of insurance referrals for all Primary Care and Care Now departments, peer to peer evaluations, verification and validation of all financial information, and Point of Service cash collection for all services assigned to ensure proper reimbursement. JOB DUTIES AND RESPONSIBILITIES: Responsible for the financial clearance of all scheduled patients by providing accurate and timely verification of all financial information and precertification/referral for all services to ensure proper reimbursement. Responsible for reviewing medical necessity of genetic testing/infusion services in addition to prior authorization to ensure revenue for services. Monitors all hospital scheduled diagnostic and surgical appointments to ensure that all cases are identified, and financial clearance is obtained. Submit prior authorizations for all STAT imaging orders for PCP and Specialty prior to date of service. Submit for insurance referrals for all PG Specialty and PCP orders and SL Care Now Departments. Submit prior authorizations for diagnostic orders placed by PG PCP and Specialty service lines. Utilizes specific Epic Work Queues designed for Prior Authorization and Insurance Referral workflows to ensure correct process is followed for proper documentation and billing in Epic. Notifies all external providers of prior authorization requirements for scheduled services. Notifies practices of all denied authorizations via in-basket message and provide peer to peer info for scheduling. Review payer medical policies and contact the health plan’s UR department for first attempt appeal mitigation. PHYSICAL AND SENSORY REQUIREMENTS: Sitting up to eight (8) hours per day, three (3) hours at a time. Consistent use of hands and fingers for typing, telephones, data entry, etc. Occasional twisting and turning. Uses upper extremities to lift and carry up to 15 pounds. Stoops, bends and reaches above shoulder level to retrieve files. Hearing as it relates to normal conversation. Seeing as it relates to general vision. EDUCATION: High school graduate or equivalent. TRAINING AND EXPERIENCE: Three years healthcare experience in a department or office with a hospital, physician’s office, or similar medical facility preferred. It is required to have at least one year in areas stated above. Strong customer service skills with knowledge of health insurances required. Must have ability to work independently. Computer experience required. Bilingual preferred. Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!! St. Luke's University Health Network is an Equal Opportunity Employer.

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