(Remote – U.S.)
🧾 About the Role
WVU Medicine is hiring a Remote Insurance Authorization Specialist III to support infusion and injection pre-authorizations. You’ll collaborate with clinical and pharmacy teams to review documentation, secure approvals, and ensure financial clearance—protecting both the patient experience and the organization’s reimbursement process.
✅ Position Highlights
• Pay: Not listed
• Employment Type: Full-Time
• Location: Remote (U.S.)
• Department: Hospital Authorization Unit
• Shift: Day
• Status: Non-Exempt
📋 What You’ll Own
• Secure prior authorizations for elective infusions and injections
• Review clinical documentation to support approvals and appeals
• Submit and follow up on authorizations through payer portals or calls
• Serve as a liaison between providers, pharmacists, and payers
• Interpret CPT/ICD-10 codes and verify insurance requirements
• Maintain work queues, Epic in-baskets, and Outlook communications
• Follow up on peer-to-peer reviews and handle denied medication appeals
• Submit elective inpatient chemo admissions and observations for authorization
• Provide retro authorizations and denial support when needed
• Participate in monthly meetings and one-on-ones
🎯 Must-Have Traits
• High school diploma + 2 years in a medical setting, or
• Associate’s degree + 1 year in a medical setting
• Experience in healthcare insurance authorization
• Working knowledge of medical terminology, ICD-10, and CPT codes
• Strong communication and time management skills
• Proficiency in Microsoft Office
• Comfortable with high-volume, multitask-heavy environments
• Typing speed of at least 25 WPM
💻 Remote Requirements
• Reliable computer, phone, and high-speed internet
• Ability to sit for extended periods and work independently
• Comfortable using Epic, insurance portals, fax systems, and standard office tools
💡 Why It’s a Win for Remote Job Seekers
• Fully remote with structured hours
• Opportunity to work in one of the country’s largest academic health systems
• Consistent workload in a mission-driven environment
• Supportive team with monthly check-ins and structured onboarding
✍️ Call to Action
If you’re experienced in healthcare authorizations, fluent in payer language, and want to make a real impact behind the scenes, apply today and join WVU Medicine’s remote authorization team.