Prior Authorization Specialist
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<p><b>About Our Company:</b><br>At Infinx, we're a fast-growing company focused on delivering innovative technology solutions to meet our clients' needs. We partner with healthcare providers to leverage automation and intelligence, overcoming revenue cycle challenges and improving reimbursements for patient care. Our clients include physician groups, hospitals, pharmacies, and dental groups.<br>We're looking for experienced associates and partners with expertise in areas that align with our clients' needs. We value individuals who are passionate about helping others, solving challenges, and improving patient care while maximizing revenue. Diversity and inclusivity are central to our values, fostering a workplace where everyone feels valued and heard.</p><p><strong>A 2025 Great Place to Work</strong><i><strong>®</strong></i></p><p>In 2025, Infinx was certified as a Great Place to Work<i>®</i> in both the U.S. and India, underscoring our commitment to fostering a high-trust, high-performance workplace culture. This marks the fourth consecutive year that Infinx India has achieved certification and the first time the company has earned recognition in the U.S.</p><b>Location: </b>Remote <br><br><b>Summary Description:</b><br><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">The Prior Authorization Specialist supports the Patient Access department in various functions, including insurance verification and coordinating prior authorization requests for medical services. This role is critical in facilitating timely patient access to healthcare by managing prior authorization processes. This position involves contacting payers for benefit information, checking authorization requirements, collecting required documentation, submitting requests to payers, and tracking authorization status.</span></span></span></span><br><br><b>Daily Responsibilities:</b><ul><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Contacting payers for eligibility and benefit information to include authorization requirements</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Obtain clinicals necessary to process authorization from specified EMR if required</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Obtain prior authorizations and pre-certifications</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Submit complete and accurate authorization requests </span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Follow up and resolve pending authorization requests </span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Maintain documentation of authorization activity </span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Stay current on payer prior authorization requirements</span></span></span></span></li></ul><b>Skills and Education:</b><ul><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">High School Diploma or GED</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Must be able to work from 8am - 5pm Central</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">2 years of experience working in a physician's office, pharmacy, or healthcare facility</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Experience with prior authorizations for Physical Therapy, Occupational Therapy, Chronic Pain Management, or Sports Medicine strongly preferred</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">5 years of experience in prior authorizations, clinical interpretation, and medical terminology preferred</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">5 years of experience in a clinical setting preferred</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Experience with TPAs (Availity, Carelon, Evicore, UHC) preferred</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Strong computer literacy, including Microsoft Office Suite and EMR/EHR systems</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><span style="font-size:11pt;"><span style="line-height:107%;"><span style="font-family:Arial, sans-serif;"><span style="color:#000000;">Ability to read, interpret, and apply medical terminology and clinical documentation</span></span></span></span></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><font color="#000000" face="Arial, sans-serif"><span style="font-size:14.6667px;">Ability to multitask and work effectively in a high-volume, fast-paced, and deadline-driven environment</span></font></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><font color="#000000" face="Arial, sans-serif"><span style="font-size:14.6667px;">Strong communication skills with the ability to interact with insurance companies via phone, fax, and electronic portals</span></font></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><font color="#000000" face="Arial, sans-serif"><span style="font-size:14.6667px;">Strong organizational skills and attention to detail</span></font></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><font color="#000000" face="Arial, sans-serif"><span style="font-size:14.6667px;">Ability to maintain confidentiality and follow HIPAA regulations</span></font></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><font color="#000000" face="Arial, sans-serif"><span style="font-size:14.6667px;">Problem-solving ability to investigate denials and determine next steps</span></font></li><li class="MsoBodyText" style="margin-left:8px;text-align:justify;"><font color="#000000" face="Arial, sans-serif"><span style="font-size:14.6667px;">Comfort navigating payer websites and electronic authorization systems</span></font></li></ul><br><b>Company Benefits and Perks:</b><br>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.<ul><li>Access to a 401(k) Retirement Savings Plan.</li><li>Comprehensive Medical, Dental, and Vision Coverage.</li><li>Paid Time Off.</li><li>Paid Holidays.</li><li>Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services.</li></ul>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.<br>