Remote Prior Authorization Specialist

About Our Company:

At Infinx, we are a dynamic and rapidly expanding company dedicated to providing innovative technology solutions and services tailored to our clients’ needs. Our mission is to collaborate closely with healthcare providers, leveraging automation and intelligence to overcome revenue cycle challenges and enhance reimbursements for patient care. We work diligently to ensure that our clients receive their revenue on time, every time. Our clientele includes physician groups, hospitals, pharmacies, and dental groups.

We are in search of experienced associates and partners who exude confidence and possess expertise in areas aligned with our clients’ requirements. We value individuals who are passionate about assisting others, adept at finding solutions to challenges, and committed to improving patient care while maximizing revenue. Inclusivity and diversity are at the core of our values, fostering a workplace where employees feel a sense of belonging, their contributions are valued, and diverse perspectives are celebrated. We believe in the power of human connection, with inclusion as the heart of our mission.

Location: Remote

Summary Description:

The Prior Authorization Specialist supports the Patient Access - Onshore department by verifying insurance and coordinating prior authorization requests for medical services. This critical role facilitates timely patient access to healthcare by managing the prior authorization process, which includes contacting payors for benefit information, checking authorization requirements, collecting necessary documentation, submitting requests, and tracking status.

Daily Responsibilities:

• Contact payors for eligibility and benefit information to include authorization requirements
• Obtain prior authorizations and pre-determinations if required/processed by payor
• Submit complete and accurate authorization requests
• Follow up and resolve pending authorization requests
• Maintain documentation of authorization activity
• Stay current on payer prior authorization requirements
• Assist in other duties as assigned

Skills and Education:

• 2+ years of experience in healthcare administration or prior authorization processes
• Experience reviewing and processing prior authorization requests for cardiology medical procedures and services
• Familiarity with medical terminology, especially in Cardiology
• Experience processing prior authorizations via payor and TPA portals
• Strong teamwork capabilities, self-motivation, and reliability
• Ability to perform clinical interpretations as part of the job responsibilities
• Familiarity with the specific procedures listed above is highly desirable
• Candidates with prior experience in prior authorizations, specifically in advanced cardiovascular and interventional procedures preferred
• Ability to collaborate with healthcare providers and payers to resolve prior authorization issues and appeals
• Medical Assistant Certification preferred or at least 5 years of experience in a provider’s office setting processing prior authorizations
• Bachelor’s degree in Healthcare Administration, Business Administration, or a related field preferred

Company Benefits and Perks:

Joining Infinx comes with an array of benefits, flexible work hours when possible, and a genuine sense of belonging to a dynamic and growing organization.

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

If you are a dedicated and experienced Prior Authorization Specialist ready to contribute to our mission and be part of our diverse and inclusive community, we invite you to apply and join our team at Infinx.