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: Fully remote role with preferred work hours 8am-5pm CT.

Summary Description:

Under general direction, this position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, and could include scheduling appointments for outpatient testing with other providers, coordinates patient appointments/orders

Daily 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.

Skills and Education:

• High School Diploma or GED as a basic qualification
• Minimum of 2 years of experience in a medical assistant role within a healthcare setting doctor's office, hospital, or clinic)
• Proficiency in processing prior authorizations, with at least 2+ years of experience
• Minimum of 2 years calling and communication with insurance companies via phone
• 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

Preferred Experience, Skills, and Education:

• 5+ years performing prior authorizations
• Experience processing PA's for Genetic Lab test
• Experience training and working remotely
• Medical Assistant Certificate

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 PA 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.

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