Prior Authorizations Specialist

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    "heading": "Prior Authorizations Specialist",
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    "description_html": "<div class=\"job_description\">\n\t\t\t\t\t<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>&#174;</strong></i></p><p>In 2025, Infinx was certified as a Great Place to Work<i>&#174;</i>&#160;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><br><span style=\"font-size:11pt;\"><span style=\"line-height:normal;\"><span style=\"font-family:Calibri, sans-serif;\"><b><span style=\"font-size:12pt;\"><span style=\"color:#2b333a;\">Location: </span></span></b><span style=\"font-size:12pt;\"><span style=\"color:#2b333a;\">Fully remote role with preferred work hours 8am-5pm CT.</span></span></span></span></span><br><br><span style=\"font-size:11pt;\"><span style=\"line-height:normal;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><span style=\"font-size:12pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"color:#000000;\">Summary Description:</span></span></span></strong></span></span></span><br><span style=\"font-size:11pt;\"><span style=\"line-height:normal;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"color:#000000;\">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</span></span></span></span></span><br><br><span style=\"font-size:11pt;\"><span style=\"line-height:normal;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><span style=\"font-size:12pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"color:#000000;\">Daily Responsibilities:</span></span></span></strong></span></span></span><ul><li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"line-height:107%;\"><span style=\"color:#000000;\">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.</span></span></span></span></span></span></li><li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"line-height:107%;\"><span style=\"color:#000000;\">Selecting accurate and pertinent medical records from patients' charts from client's EMR.</span></span></span></span></span></span></li><li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"line-height:107%;\"><span style=\"color:#000000;\">Obtaining demographic information and verifying insurance information.</span></span></span></span></span></span></li><li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"line-height:107%;\"><span style=\"color:#000000;\">Provide all required clinical information to insurance companies necessary to facilitate the authorization process.</span></span></span></span></span></span></li><li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"line-height:107%;\"><span style=\"color:#000000;\">Perform complete documentation (within company software or client's EMR) on all prior authorizations follow-ups and determinations appropriately and in a timely manner.</span></span></span></span></span></span></li><li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"line-height:107%;\"><span style=\"color:#000000;\">Maintain and update internal listing of insurance carriers that require authorization, their processes, and phone and fax numbers.</span></span></span></span></span></span></li><li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-size:12pt;\"><span style=\"line-height:107%;\"><span style=\"color:#000000;\">Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements.</span></span></span></span></span></span></li></ul><br><span style=\"font-size:11pt;\"><span style=\"line-height:normal;\"><span style=\"font-family:Calibri, sans-serif;\"><strong><span style=\"font-size:12pt;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"color:#000000;\">Skills and Education:</span></span></span></strong></span></span></span><ul><li style=\"text-align:justify;margin-left:8px;\"><font color=\"#000000\" face=\"Calibri, sans-serif\"><span style=\"font-size:16px;\">High School Diploma or GED as a basic qualification</span></font></li><li style=\"text-align:justify;margin-left:8px;\"><font color=\"#000000\" face=\"Calibri, sans-serif\"><span style=\"font-size:16px;\">Proficiency in processing prior authorizations, with at least 5+ years of experience</span></font></li><li style=\"text-align:justify;margin-left:8px;\"><font color=\"#000000\" face=\"Calibri, sans-serif\"><span style=\"font-size:16px;\">Minimum of 2 years calling and communication with insurance companies via phone</span></font></li><li style=\"text-align:justify;margin-left:8px;\"><font color=\"#000000\" face=\"Calibri, sans-serif\"><span style=\"font-size:16px;\">Familiarity with medical terminology</span></font></li><li style=\"text-align:justify;margin-left:8px;\"><font color=\"#000000\" face=\"Calibri, sans-serif\"><span style=\"font-size:16px;\">Strong teamwork capabilities, self-motivation, and reliability</span></font></li><li style=\"text-align:justify;margin-left:8px;\"><font color=\"#000000\" face=\"Calibri, sans-serif\"><span style=\"font-size:16px;\">Basic computer literacy</span></font></li><li style=\"text-align:justify;margin-left:8px;\"><font color=\"#000000\" face=\"Calibri, sans-serif\"><span style=\"font-size:16px;\">Reliable, must have the ability to work well in a team setting, and be a self-starter</span></font></li></ul><div style=\"text-align:justify;margin-left:8px;\"><font color=\"#000000\" face=\"Calibri, sans-serif\"><span style=\"font-size:16px;\"><b>Preferred Experience, Skills, and Education:</b></span></font>",
    "description_text": "About Our Company:\nAt 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.\nWe'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.\n A 2025 Great Place to Work ®\n 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.\n Location: Fully remote role with preferred work hours 8am-5pm CT.\n Summary Description:\n 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\n 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.\n Selecting accurate and pertinent medical records from patients' charts from client's EMR.\n Obtaining demographic information and verifying insurance information.\n Provide all required clinical information to insurance companies necessary to facilitate the authorization process.\n Perform complete documentation (within company software or client's EMR) on all prior authorizations follow-ups and determinations appropriately and in a timely manner.\n Maintain and update internal listing of insurance carriers that require authorization, their processes, and phone and fax numbers.\n Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements.\n Skills and Education: High School Diploma or GED as a basic qualification\n Proficiency in processing prior authorizations, with at least 5+ years of experience\n Minimum of 2 years calling and communication with insurance companies via phone\n Familiarity with medical terminology\n Strong teamwork capabilities, self-motivation, and reliability\n Basic computer literacy\n Reliable, must have the ability to work well in a team setting, and be a self-starter\n Preferred Experience, Skills, and Education:",
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