Job Description

Retina Prior Authorization Specialist – Fully Remote

Location: Fully Remote – EST, CST, or MST Only

Pay: $22–$29/hour, based on experience

Schedule: Monday–Friday, 8:00 AM–5:00 PM

Employment Type: Direct Hire

Work Setting: 100% Remote

Time Zone Requirement: Candidates in the Pacific Time Zone (PST/PDT) are not eligible.

Benefits: Medical, Dental, Vision, 401K, PTO

Position Overview

Addison Group is hiring for our client, a growing national ophthalmology and retina organization, seeking an experienced Retina Prior Authorization Specialist to join its Revenue Cycle team.

This position focuses on obtaining insurance authorizations for retina-specific treatments and intravitreal injectable medications , navigating payer requirements, and coordinating with clinical practices to ensure patients receive timely access to treatment.

Recent retina authorization experience is required. Candidates must have hands-on knowledge of retina medications, insurance authorization processes, and manufacturer copay assistance programs.

Key Responsibilities

• Obtain prior authorizations for retina treatments and intravitreal injectable drugs
• Submit and track authorization requests through commercial and government insurance portals
• Coordinate with retina practices to prevent treatment delays
• Complete benefits investigations and verify drug coverage requirements
• Navigate manufacturer portals and assist with copay assistance programs
• Monitor authorization expiration dates and proactively request renewals
• Research authorization issues, payer requirements, and missing documentation
• Maintain accurate authorization records within EMR and billing systems
• Communicate authorization updates with clinical and Revenue Cycle teams
• Stay current on payer guidelines, drug coverage policies, and manufacturer assistance programs
• Maintain HIPAA compliance and accurate patient documentation

Qualifications

• Recent retina-specific prior authorization experience required
• Experience obtaining authorizations for intravitreal injectable medications
• Strong understanding of retina treatments, specialty medications, and drug coverage requirements
• Experience with commercial insurance, Medicare, and other government payers
• Familiarity with manufacturer drug portals, copay assistance, and patient support programs
• Comfortable navigating insurance payer portals and researching authorization requirements
• Experience tracking and renewing expiring authorizations
• Strong attention to detail, organization, and follow-through
• Excellent communication and problem-solving skills
• Ability to work independently in a fully remote environment

Ideal Candidate

We are looking for someone who already understands the complexities of retina drug authorizations and can confidently manage the process from benefits investigation through final approval.

The strongest candidates will be proactive, detail-oriented, and experienced with retina injectable medications, manufacturer assistance programs, and payer-specific authorization requirements.

Why Consider This Opportunity?

• 100% remote position
• $22–$29/hour, based on experience
• Direct-hire opportunity with an established national organization
• Growing company with opportunities for career advancement
• Strong history of promoting employees internally
• Competitive benefits and paid time off
• Opportunity to specialize in retina Revenue Cycle operations

Remote Work Requirements

Candidates must reside in the Eastern, Central, or Mountain Time Zones.

Candidates located in the Pacific Time Zone will not be considered.

 Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.

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