Prior Authorization Representative

$26-$28/hour | Fully Remote | Monday-Friday, 9:00 AM-6:00 PM EST | 3 Openings

Medix is hiring experienced Prior Authorization Representatives to support Thesis Care, a growing healthcare technology company that partners with outpatient specialty practices.

This team supports prior authorization workflows across a range of specialties, including areas such as gastroenterology, endocrinology, behavioral health, neurology, telehealth, cardiology, imaging, specialty medications, and other outpatient services.

We're looking for people who already understand the authorization process, are comfortable working directly with insurance carriers, and can get up to speed quickly in a fast-moving remote environment.

• Review physician orders and supporting medical documentation for accuracy and completeness
• Submit prior authorization requests for outpatient specialty services, procedures, imaging, and medications
• Work across a variety of specialties and payer requirements
• Communicate with commercial and government insurance carriers to obtain approvals, clarify requirements, and resolve authorization issues
• Track pending authorizations and follow up to avoid delays in care
• Identify missing documentation or information needed to move cases forward
• Document authorization activity accurately and maintain compliance with payer requirements
• Work closely with clinical and operations teams when questions or escalations arise

The long-term goal is approximately 40 authorization cases per day.

This is a rolling metric and is not expected immediately during training. Productivity and quality expectations will be reviewed as the team gets comfortable with the workflow.

• 3 years of prior authorization experience
• Strong experience working with commercial insurance plans
• Medicare and/or Medicaid experience is a plus
• Experience working with outpatient specialty authorizations
• Comfortable communicating directly with insurance carriers
• Experience reviewing physician orders and supporting medical documentation
• Strong follow-up and organizational skills
• Comfortable managing a high-volume queue
• Strong computer skills and ability to learn new systems quickly
• Able to work independently in a remote environment
• Comfortable asking questions, taking feedback, and adapting quickly

eClinicalWorks (eCW) experience is preferred but not required.

Training is expected to be approximately one week, followed by a quick transition into the day-to-day workload.

This is a fast-moving environment. You'll have support and people to ask questions, but Thesis is looking for people who can take ownership of their work and become increasingly independent as they learn the process.

The strongest performers tend to be comfortable learning on the job, communicating when something is unclear, managing their own queue, and adjusting as workflows change or improve.

Pay: $26-$28/hour
Schedule: Monday-Friday, 9:00 AM-6:00 PM EST
Lunch: 1-hour unpaid lunch
Location: Fully remote within the U.S.
Employment: W-2 through Medix
Payroll: Weekly
Benefits: Eligibility begins after 30 days
Equipment: Company-provided equipment

This is initially a 3-month contract.

There is strong potential for extension based on performance and business need. Similar contract positions have continued well beyond the original assignment period.

Permanent opportunities may also become available farther down the line, but they are not immediate or guaranteed. Some contractors have remained in long-term contract assignments for 1-2 years as teams and business needs continued to grow.

Company equipment is provided.

There is a temporary refundable equipment deposit:

• $50 deducted per paycheck for the first 10 weeks
• $500 total
• No upfront payment
• Refunded according to the equipment-return policy

For California Applicants:

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).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. 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.

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?