Quality Assurance Analyst | Prior Authorization

Department: Prior Authorization Location: Remote-US Employment Type: Full-Time IVX Health is seeking a Quality Assurance Analyst to safeguard the quality, compliance, and performance of our Intake and Prior Authorization workflows. This role plays a critical part in reducing denial risk, strengthening documentation accuracy, and improving SLA performance through structured case audits and data-driven process improvement. If you have strong prior authorization experience and enjoy identifying trends, mitigating risk, and driving operational improvement, this role offers meaningful impact within a growing healthcare organization. ### What You'll Do Case Auditing & Compliance

• Conduct structured audits of Intake and Prior Authorization cases
• Evaluate documentation accuracy, medical necessity support, and adherence to internal SOPs and payer policies
• Maintain defensible audit documentation and compliance standards

Trend Analysis & Reporting

• Monitor SLA performance, denial trends, and recurring workflow errors
• Develop recurring QA reports with actionable insights
• Identify systemic process vulnerabilities and training gaps

Performance Improvement

• Document findings clearly and administer QA result notifications
• Partner with Operations leadership on corrective action plans
• Recommend workflow and SOP updates based on audit findings
• Support readiness for internal audits and compliance reviews

### What We're Looking For

• High School Diploma or GED required; Associate degree in a healthcare-related field (Medical Office Management, Medical Insurance, Medical Coding, or related) strongly preferred
• Minimum 3+ years of experience in prior authorization, benefits investigation, or revenue cycle operations
• Experience conducting documentation audits or quality assurance reviews in a healthcare environment
• Demonstrated knowledge of medical necessity review standards, prior authorization workflows, payer policies, and benefits investigation best practices
• Experience utilizing Excel for data tracking and analysis, as well as audit management or reporting platforms required
• Strong analytical thinking, attention to detail, and organizational skills
• Clear written and verbal communication skills
• Working knowledge of HIPAA and healthcare compliance standards
• Experience with EHR, practice management, or revenue cycle systems

About IVX Health IVX Health is a national provider of infusion and injection therapy for individuals managing chronic conditions like Rheumatoid Arthritis, Crohn's Disease, and Multiple Sclerosis. We're transforming the way care is delivered with a focus on patient comfort and convenience. Our commitment to exceptional care extends to our employees as well—we empower our team to thrive while living our core values: Be Kind, Do What's Right, Never Settle, Make It Happen, and Enjoy the Ride. Our Mission: To improve the lives of those we care for by redefining the care experience Our Vision: To be the nation's preferred destination for pharmaceutical care of complex chronic conditions Our Commitment: To deliver an unmatched care experience with a foundation in world class service and clinical excellence

Benefits

We Offer

• Comprehensive Healthcare – Medical, dental, and vision coverage, including prescription drug plans and telemedicine services.
• Flexible Savings Options – Choose from Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA) to manage healthcare costs.
• Supplemental Protection – Accident, critical illness, and hospital indemnity plans to provide additional financial security.
• Dependent Care FSA – Pre-tax savings for eligible childcare and dependent care expenses.
• 401(k) Retirement Plan – Secure your future with a competitive company match.
• Disability Coverage – Voluntary short-term and long-term disability plans to protect your income.
• Fertility and Family Support – Resources and benefits designed to support fertility care and family planning.
• Life and AD&D Insurance – Financial protection for you and your loved ones.
• Counseling and Wellness Support – Free resources to support emotional, physical, and financial well-being.
• Education Assistance – Tuition reimbursement and certification support to help you grow in your career.
• Continuing Education – Access to a CEU library for ongoing professional development.
• Charitable Giving and Volunteer Program – Matched donations and

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