[Hiring] Prior Authorization Specialist @Infinx

Role 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.

• Obtain timely prior authorization or pre-determinations from all insurances, to include commercial plans, Medicaid, and Medicare Advantage plans, following the company's established policies and protocols.
• Select accurate and pertinent medical records from patients' charts from client's EMR.
• Obtain demographic information and verify 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.

Qualifications

• 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

Requirements

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

Benefits

• 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.