Job Details

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Join a high-performing team where your attention to detail and communication skills directly support patient care. As a Remote PriorAuthorization Specialist, you'll play a key role in ensuring patients receive timely access to services by securing accurate authorizations and verifying insurance coverage. This is a fast-paced, metrics-driven role ideal for candidates who enjoy problem-solving, navigating insurance requirements, and providing outstanding service to both patients and clinical teams.

Schedule:

M-F 9 AM - 6 PM CST (8-5 in training)

Requirements:

• 3-5+ years of experience in prior authorizations/eligibility/referrals
• 1+ years of remote work experience
• 1+ years of call center experience

Key Responsibilities

• Manage a high volume of prior authorization cases with productivity metrics linked to volume and quality.
• Ensure timely authorization approvals to minimize appointment cancellations.
• Maintain strong call metrics, including adherence to 80% "ready" status during scheduled shifts.
• Answer customer inquiries regarding authorization, eligibility, and estimates.
• Utilize worklists to contact Utilization Management Companies or Insurance Payers for authorization requests.
• Execute eligibility searches and update necessary insurance information in the RIS.
• Accurately document all authorization and eligibility details in relevant application fields.
• Communicate medical necessity denials or cases requiring peer review to referring physicians.
• Validate all authorizations for accuracy before patient exams.
• Contact patients to update insurance information and verify active eligibility.
• Complete a 30-90 day ramp-up period to meet productivity and quality targets.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.