Prior Authorization Specialist

Note this is a remote role, but must reside in EST time zone 

Make an Impact Where It Matters Most

At Valley Vital Care, the Authorization Specialist plays a critical role in helping patients access and continue the therapy they need. As the approval checkpoint of the patient journey, you will be responsible for securing prior authorizations, navigating payer requirements, managing appeals, and ensuring approvals remain active so there are no unnecessary interruptions in patient care.

We are looking for an organized, persistent, detail-oriented professional who understands the importance of timely follow-up, accurate documentation, and strong communication with payers and internal teams.

Whether you are building your authorization experience or are an experienced authorization professional ready to take on complex cases and appeals, Valley Vital Care offers opportunities across Authorization Specialist I, II, and III.

What You’ll Do

• Submit prior authorizations through payer portals and other appropriate channels.
  
• Own and coordinate the clinical documentation required to support authorization approvals.
  
• Track authorization submissions and follow up with payers through resolution.
  
• Monitor authorization timelines and proactively address potential delays.
  
• Manage appeals and coordinate peer-to-peer reviews for denied requests.
  
• Secure authorization renewals before existing approvals expire and potentially interrupt patient therapy.
  
• Coordinate authorization timelines closely with Intake, Patient Access, and Pharmacy teams.
  
• Accurately and timely document all authorization activity.
  
• Identify and escalate complex, delayed, or challenging payer issues appropriately.
  
• Maintain strong organization and follow-through across multiple patient cases.
  
• Help ensure patients can start and continue therapy without avoidable authorization-related delays.
  

Requirements

• High school diploma or equivalent.
  
• 0–1 year of prior authorization or healthcare administrative experience.
  
• Familiarity with insurance and payer terminology.
  
• Strong organization and follow-through.
  
• Ability to work effectively with guidance and learn new payer processes.
  
• Managing appeals independently.
  
• Handling complex payers and difficult authorization submissions.
  
• Proactively coordinating renewals across your assigned patient panel.
  
• Resolving authorization issues with greater independence and limited guidance.
  
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The ideal candidate is someone who is persistent, highly organized, detail-oriented, and passionate about helping patients access care. You understand that authorization work requires more than simply submitting paperwork—you must own each request through resolution, anticipate potential issues, communicate effectively with internal teams, and act quickly when an authorization is at risk of delaying therapy.

You are comfortable working with multiple payers, navigating portals, gathering clinical documentation, and following up consistently until an issue is resolved.

For more experienced candidates, we are especially interested in professionals who have demonstrated success with denials, appeals, peer-to-peer coordination, complex payers, and mentoring or training others.

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Benefits

If you are looking for an opportunity where your attention to detail, persistence, and insurance expertise directly help patients receive the care they need, we would love to hear from you.

Apply today to join Valley Vital Care as an Authorization Specialist.

 #LI-CW1

#valleyvitalcare