Prior Authorizations Specialist

Reposted 9 Days Ago
Be an Early Applicant
Country States, Pájaros Barrio, Bayamón, PRI
In-Office
Senior level
Healthtech
The Role
The Prior Authorizations Specialist is responsible for obtaining pre-certifications and authorizations for medical procedures and medications, coordinating patient appointments, and ensuring timely documentation in compliance with insurance protocols and HIPAA regulations.
Summary Generated by Built In

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: 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
  • Proficiency in processing prior authorizations, with at least 5+ years of experience
  • Minimum of 2 years calling and communication with insurance companies via phone
  • Familiarity with medical terminology
  • 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:
  • Experience processing PAs for acute hospital outpatient ancillary services
  • Experience training and working remotely

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.

Skills Required

  • High School Diploma or GED
  • 5+ years processing prior authorizations
  • 2 years calling insurance companies
  • Familiarity with medical terminology
  • Basic computer literacy

Infinx Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Infinx and has not been reviewed or approved by Infinx.

  • Fair & Transparent Compensation Pay is considered competitive in several markets, and U.S. postings show clear hourly ranges for entry- to mid-level revenue-cycle roles. Salary is characterized as on time and dependable.
  • Healthcare Strength U.S. offerings include medical, dental, and vision, with some instances of employer-paid medical coverage and HSA support. Coverage is described as strong in certain cases.
  • Retirement Support A 401(k) with employer matching is included in U.S. materials and some role listings. This indicates structured retirement support alongside core health coverage.

Infinx Insights

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The Company
HQ: San Jose, CA
1,542 Employees
Year Founded: 2012

What We Do

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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