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Prior Authorization & Benefits Verification Specialist

Role overview

Summary

This role supports the Patient Access Onshore department by managing prior authorization processes to facilitate timely patient access to healthcare. You will coordinate with payers and provider offices to ensure accurate and efficient authorization requests, contributing to improved patient care and revenue cycle management.

Qualifications

  • High School Diploma or equivalent.
  • 2+ years of experience in prior authorization and insurance eligibility/benefits verification.
  • Experience verifying coverage, deductibles, copays, coinsurance, and authorization requirements.
  • Familiarity with medical terminology, CPT/ICD-10 codes, payer portals, and electronic health record systems.
  • Preferred: Experience resolving authorization denials and supporting appeals

Responsibilities

  • Contact payers for eligibility and benefit information including authorization requirements
  • Obtain prior authorizations and pre-certifications
  • Submit complete and accurate authorization requests
  • Follow up and resolve pending authorization requests

Key facts

  • Remote from: United States
  • Full time
  • Mid-level (2-5 years)
  • Benefits Specialist
  • English

Hard skills

Other skills

  • Detail Oriented
  • Communication
  • Time Management

About the company

Infinx logo

Infinx

  • Digital Health
  • 1,001–5,000
Infinx Healthcare provides innovative and scalable prior authorization and revenue cycle management solutions for healthcare providers, hospitals, imaging centers, and laboratories. Combining intelligent, cloud-based software driven by artificial intelligence and automation, with exception handling by our certified prior authorization and billing specialists, Infinx helps clients preserve and capture more revenue, enabling them to shift focus from burdensome administrative details to billable patient care.

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Job description

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:
This remote Prior Authorization Specialist supports the Patient Access Onshore department in various functions, insurance verification and coordinating prior authorization requests for medical services. This position and is critical in facilitating timely patient access to healthcare by managing prior authorization processes. This role 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 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 equivalent
  • 2+ years of experience in prior authorization and insurance eligibility/benefits verification
  • Experience verifying coverage, deductibles, copays, coinsurance, and authorization requirements
  • Ability to submit and track authorization requests, follow up with payers, and coordinate supporting documentation with provider offices
  • Familiarity with medical terminology, CPT/ICD-10 codes, payer portals, and electronic health record systems
  • Strong attention to detail, communication, organization, and follow-up skills
  • Ability to manage multiple requests, meet turnaround times, and maintain patient confidentiality
  • Experience with radiology/imaging and laboratory services preferred
  • Experience resolving authorization denials and supporting appeals preferred

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 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.
 

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