Prior Authorization Specialist

Summary

Join Infinx, a rapidly growing technology company providing innovative healthcare solutions, as a Pre-Authorization Specialist. This fully remote position focuses on obtaining timely pre-certifications and pre-authorizations for procedures and medications. You will work with various insurance plans, maintain accurate patient records, and ensure complete documentation within company software. The role requires strong teamwork, self-motivation, and familiarity with medical terminology. Infinx offers a comprehensive benefits package including medical, dental, vision, 401k, paid time off, and additional perks.

Requirements

• High School Diploma or GED
• 1+ year working in an office setting
• Strong teamwork capabilities, self-motivation, and reliability
• Basic computer literacy
• Ability to work well in a team setting and be a self-starter

Responsibilities

• Obtain timely prior authorization or pre-determinations from all insurances, to include commercial plans, Medicaid, Medicaid and Medicare Advantage plans, following the company's established policies and protocols
• Select accurate and pertinent medical records from patients' charts from client's EMR
• Obtain demographic information and verify insurance information
• Provide all required clinical information to insurance companies necessary to facilitate the authorization process
• Perform complete documentation (within company software or client's EMR) on all prior authorizations follow-ups and determinations appropriately and in a timely manner
• Maintain and update internal listing of insurance carriers that require authorization, their processes, and phone and fax numbers
• Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements

Preferred Qualifications

• Healthcare office or facility experience
• Familiarity with medical terminology, especially in Oncology

Benefits

• Flexible work hours when possible
• Access to a 401(k) Retirement Savings Plan
• Comprehensive Medical, Dental, and Vision Coverage
• Paid Time Off
• Paid Holidays
• Pet Care Coverage
• Employee Assistance Program (EAP)
• Discounted services