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, particularly in oncology. Infinx offers a comprehensive benefits package including medical, dental, vision, 401k, paid time off, and additional perks like pet care coverage and an employee assistance program.

Requirements

• High School Diploma or GED
• 1+ year of healthcare prior authorizations experience
• Experience in submitting prior authorizations
• Familiarity with medical terminology, especially in Oncology
• Strong teamwork capabilities, self-motivation, and reliability
• Basic computer literacy
• Reliable, must have the 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
• Selecting accurate and pertinent medical records from patients' charts from client's EMR
• Obtaining demographic information and verifying 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

Preferred work hours 8am-5pm CT

Benefits

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