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Prior Authorization Specialist | Temporary

Remote · USA Full-time New today

About Our Company: 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. 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. A 2025 Great Place to Work® In 2025, Infinx was certified as a Great Place to Work® 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. Location: Remote

Summary

Description: 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. Daily Responsibilities:

  • Contacting payers for eligibility and benefit information to include authorization requirements
  • Obtain clinicals necessary to process authorization from specified EMR if required
  • Obtain prior authorizations and pre-certifications
  • 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

Skills and Education:

  • High School Diploma or GED
  • Must be able to work from 8am - 5pm Central
  • 2 years of experience working in a physician's office, pharmacy, or healthcare facility
  • Experience with prior authorizations for Physical Therapy, Occupational Therapy, Chronic Pain Management, or Sports Medicine strongly preferred
  • 5 years of experience in prior authorizations, clinical interpretation, and medical terminology preferred
  • 5 years of experience in a clinical setting preferred
  • Experience with TPAs (Availity, Carelon, Evicore, UHC) preferred
  • Strong computer literacy, including Microsoft Office Suite and EMR/EHR systems
  • Ability to read, interpret, and apply medical terminology and clinical documentation
  • Ability to multitask and work effectively in a high-volume, fast-paced, and deadline-driven environment
  • Strong communication skills with the ability to interact with insurance companies via phone, fax, and electronic portals
  • Strong organizational skills and attention to detail
  • Ability to maintain confidentiality and follow HIPAA regulations
  • Problem-solving ability to investigate denials and determine next steps
  • Comfort navigating payer websites and electronic authorization systems

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. Apply tot his job Apply To this Job

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