Prior Authorization Representative (Remote) - 257180
Prior Authorization Specialist – DME/HME & Infusion 100% Remote | $22–$26/hour | W-2 Contract-to-Hire | Equipment Provided Position Overview Medix is hiring a Prior Authorization Representative for a growing healthcare technology organization supporting authorization workflows across DME/HME, infusion, specialty pharmacy, and other healthcare service lines. This is a fully remote, high-volume prior authorization role focused on submitting and tracking authorization requests, reviewing supporting documentation, communicating with payers, and ensuring cases move accurately and efficiently through the authorization process. The position also uses proprietary AI-assisted healthcare technology integrated into existing authorization workflows. What You’ll Do
- Submit and track prior authorization requests through payer portals
- Monitor authorization status and follow up on pending requests
- Respond to requests for additional clinical or supporting documentation
- Review authorization submissions for completeness and accuracy
- Maintain complete and accurate documentation throughout the authorization process
- Follow payer-specific submission requirements and established workflows
- Navigate Medicare, Medicaid, and commercial payer requirements
- Utilize proprietary AI-assisted tools within authorization workflows
- Collaborate with internal teams to resolve authorization issues and escalations
- Manage a high-volume workload while maintaining quality and productivity standards
What We’re Looking For
- Prior authorization experience within DME/HME, home infusion, specialty pharmacy, infusion therapy, or a related healthcare service line
- Hands-on experience submitting authorization requests through payer portals
- Strong understanding of payer authorization and documentation requirements
- Experience working with Medicare, Medicaid, and/or commercial insurance
- Ability to independently track cases and follow up on outstanding requirements
- Strong attention to detail, organization, and follow-through
- Ability to work efficiently within structured, high-volume workflows
- Comfortable navigating web-based healthcare systems and new technology platforms
Preferred Experience
- Durable Medical Equipment / Home Medical Equipment
- Respiratory DME, PAP/CPAP/BiPAP, oxygen, mobility, or other DME service lines
- Home infusion or ambulatory infusion
- Specialty pharmacy / specialty infusion
- Medicare reimbursement or authorization
- Noridian and/or CGS portal experience
- Benefits verification or benefits investigation
- Reimbursement or revenue-cycle operations
- Intake and referral processing
- Authorization denials, follow-up, and escalation
- AI-assisted healthcare workflows or other technology-enabled authorization systems
Position Details Pay: $22–$26/hour, based on experience Schedule: Monday–Friday, 9:00 AM–6:00 PM EST Location: 100% Remote Employment: W-2 contract-to-hire through Medix Contract Period: Approximately 800 hours / 4–5 months Payroll: Weekly through Medix Benefits: Full benefits available after 30 days Equipment: Company-issued equipment provided Equipment Security Deposit A refundable $500 IT equipment security deposit applies to company-issued equipment. There is no upfront payment required . The deposit is collected through $50 weekly payroll deductions during the first 10 weeks and refunded upon conversion to permanent employment or return of the equipment in accordance with the equipment policy. Candidates with hands-on experience managing payer authorizations within DME/HME, infusion, specialty pharmacy, or other documentation-heavy healthcare services are strongly encouraged to apply.