Top 26 Prior authorization specialist Jobs in Malvern, Pa

Patient Care Call Center Coordinator/Insurance Verification Specialist
The Pennsylvania Pain & Spine Institute —Chalfont, PA
- $19 - $23 an hour
- Full-time
- Physical & Rehabilitation Medicine
- HIPAA
- Administrative experience
- 401(k)
- Paid time off
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Senior Patient Access Specialist
Ensemble RCM LLC —Phoenixville, PA
- $18.65 - $19.90 an hour
- Full-time
- Management
- Hospital
- Customer service
- Tuition reimbursement

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Referral Specialist
PrimaryOne Health —Columbus, OH
Utilizes internal software and telephone system to enter or retrieve data related to the referral/scheduling of appointments.
Prior Authorization Specialist
Quiet Waters Clinics —Columbus, OH
Collaborate with clinical staff to gather necessary medical records, clinical notes, and supporting documentation for authorization submissions.
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Patient Care Call Center Coordinator/Insurance Verification Specialist

The Pennsylvania Pain & Spine Institute -
Chalfont, PA

Quick Apply

Job Details

Full-time
$19 - $23 an hour

Benefits

401(k)
Paid time off

Qualifications

Interpersonal skills
Health insurance information
Medical scheduling
Administrative experience
Medical administrative support
Attention to detail
Health information management
Medical terminology

Full Job Description

<Overview>
Join our medical specialty practice as a call center follow up Patient Care Call Center Coordinator/Insurance Verification Specialist, where your energy and organizational skills will directly impact patient experiences and clinic operations. In this vital role, you will coordinate patient appointments, manage medical records, and ensure seamless communication between patients and healthcare providers. Your proactive approach will help create a welcoming environment while maintaining accuracy in scheduling and documentation. This position offers an exciting opportunity to be at the heart of patient care delivery, supporting both clinical teams and patients with enthusiasm and professionalism.

<Responsibilities>

Schedule appointments for established patients across both practice locations
Manage high-volume inbound and outbound calls with professionalism and empathy
Coordinate prior authorizations for medications and specialist referrals
Verify patient insurance coverage through our online portal prior to appointments and confirm plans are active
Enter copays, co-insurance, deductibles, and out-of-pocket amounts into the patient record
Upload insurance verifications and insurance card copies into the patient's attachments
Review insurance cards on file and coordinate with the front desk when cards need to be collected
Check whether each patient's plan requires a referral, and call the patient or their PCP office to obtain one if needed
Maintain a running list of pending referrals and file received referrals in the attachments section
Answer patient and staff questions about insurance, benefits, and plan changes by phone and email
Call insurance companies directly to verify eligibility when needed
Update patient insurance information as changes occur
Stay current on which insurance plans the practice accepts and does not accept
Assist with insurance verification, billing inquiries, and authorization follow-through
Communicate with patients regarding treatment plans, appointments, and medication refill requests
Verify insurance coverage and perform insurance eligibility checks to facilitate smooth billing processes.
Maintain detailed medical records and ensure compliance with HIPAA regulations to protect patient confidentiality.
Provide exceptional patient service by answering multi-line phone systems with professionalism, practicing excellent phone etiquette, and addressing patient inquiries promptly.
Collaborate with healthcare providers to review documentation for accuracy and completeness, ensuring proper care plans are documented in the EMR system.

<Qualifications>

Experience with medication prior authorizations and insurance billing (strongly preferred)
Familiarity with specialty practice workflows — pain management, orthopedics, or PM&R a plus
Strong phone communication skills and the ability to manage multiple tasks simultaneously
Proven experience in medical office management or healthcare administrative support within a clinical setting.
Strong knowledge of EMR systems.
Familiarity with medical billing procedures including insurance verification
Excellent computer skills with proficiency in health information management software.
Exceptional organizational skills with attention to detail in documentation review and data entry tasks.
Outstanding customer service skills combined with professional phone etiquette for handling multi-line phone systems effectively.
Knowledge of HIPAA regulations and medical terminology necessary for maintaining confidentiality and accurate recordkeeping.
Prior clinic or hospital experience involving surgical scheduling, front desk operations, or dental office experience is highly desirable.

Pay: $19.00 - $23.00 per hour

Benefits:

401(k)
Paid time off

Work Location: In person

Quick Apply

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prior authorization specialist jobs in malvern, pa

Patient Care Call Center Coordinator/Insurance Verification Specialist

Senior Patient Access Specialist

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