Top 36 Prior authorization Jobs in Harrisburg, Pa

Authorization Specialist
OSS Health —York, PA
- Monday to Friday
- Hybrid work
- Anatomy knowledge
- Mid-level
- High school diploma or GED
- Profit sharing
- Disability insurance
Medical Bill Review Supervisor
Hoover Rehabilitation Services, Inc. —Mechanicsburg, PA
- Full-time
- Hybrid work
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Case Manager (Pool/PRN)
Connections Health Solutions —Harrisburg, PA
- Full-time
- Adults
- Mid-level
- Master's degree
- Paid parental leave
- Health savings account
Quick Apply
Registered Nurse Clinical Case Manager - Heart and Vascular Services
Penn State Health —Hershey, PA
- Full-time
- Background check
- Surgery
- RN License
- Paid parental leave
- Health insurance
Medical Office Associate - Harrisburg
Penn State Health —Harrisburg, PA
- Full-time
- Background check
- High school diploma or GED
- Geriatrics
- Paid parental leave
- Health insurance
Patient Access Representative
Planned Parenthood Keystone —Harrisburg, PA
- $22 an hour
- Full-time
- Hybrid work
- Computer literacy
- Adults
- Computer skills
- AD&D insurance
- Disability insurance
Quick Apply
Medical Bill Review/Coding Specialist
Health Options & Management Services —New Cumberland, PA
- Email
- Computer literacy
- Mid-level
- Office
Transplant Financial Coordinator - Bone Marrow Transplant
Penn State Health —Hershey, PA
- Full-time
- Background check
- Customer service
- Mid-level
- Paid parental leave
- Health insurance
Patient Representative
Advanced Medical Management LLC —Harrisburg, PA
- $20 an hour
- Microsoft Outlook
- Computer literacy
- Pass drug screening
- Paid training
- Health savings account
Quick Apply
PART-TIME MEDICAL ASSISTANT
Pennsylvania Headache Center —Camp Hill, PA
- $20 - $22 an hour
- Part-time
- Private practice
- HIPAA
- Mid-level
Quick Apply
14d
Nutrition Care Coordinator
Option Care Enterprises, Inc. —Harrisburg, PA
- $17.02 - $28.38 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Organizational skills
- Health savings account
- Health insurance
Quick Apply
1d
Central Insurance Referral Specialist II - Lemoyne
UPMC —Lemoyne, PA
- $20.45 - $30.68 an hour
- Full-time
- Anatomy knowledge
- Microsoft Outlook
- Medical office experience
2d
Front Desk Receptionist
US Foot & Ankle Specialists —Mechanicsburg, PA
- Microsoft Excel
- Microsoft Outlook
- Sales
- Paid holidays
- Disability insurance
Quick Apply
13d
Medical Assistant
DermDox Dermatology —Camp Hill, PA
- $20 - $24 an hour
- Full-time
- Microsoft Excel
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
7d
Financial Counselor | Oncology
UPMC —Mechanicsburg, PA
- $19.41 - $29.15 an hour
- Full-time
- Hybrid work
- Word processing
- Medical office experience
- HIPAA
Clinical Care Assistant
CarePath Injury Centers of Pennsylvania —Carlisle, PA
- $17.00 - $27.87 an hour
- Full-time
- Background check
- Spanish
- English
- Paid training
- Paid holidays
Quick Apply
Complex Rehab Lead - Harrisburg, PA
Blackburn's Physicians Pharmacy, Inc. —Harrisburg, PA
- Full-time
- Anatomy knowledge
- Microsoft Outlook
- Mid-level
Quick Apply
Medical Assistant
DCSS MANAGEMENT LLC —Camp Hill, PA
- Microsoft Excel
- Mid-level
- High school diploma or GED
Quick Apply
8d
Customer Service Specialist- Sycamore Square Family Medicine (Full Time/Day & Evening Shift)
Penn Medicine —Elizabethtown, PA
- Full-time
- Medical office experience
- Administrative experience
- High school diploma or GED
- Tuition reimbursement
Quick Apply
Field Reimbursement Manager
Valeris, Inc. —Harrisburg, PA
- Full-time
- Background check
- Pass drug screening
- HIPAA
- Health savings account
- AD&D insurance
Quick Apply

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Authorization Specialist

OSS Health -
York, PA

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Job Details

Benefits

Profit sharing
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Opportunities for advancement
Life insurance

Qualifications

Anatomy knowledge
Phone communication
Medical insurance coverage verification
High school diploma or GED
ICD-10
Productivity software
Medical terminology
Office phone management

Full Job Description

At OSS Health, our mission is to continually strive to be the healthcare leader in quality, innovation and value. We make every effort to understand and exceed the expectations and needs of our patients. We are committed to providing an environment that is safe, respectful, and dignified at all times.

Joining OSS Health means joining a culture of excellence and teamwork, with a strong focus on employee development and community support. OSS Health offers a great work environment, professional development opportunities, meaningful careers, and competitive compensation.

Are you ready to provide a 5-star “OSSOME” experience? Apply today!

JOB SUMMARY: The basic function of the Authorization Specialist is to verify benefits/eligibility and obtain authorizations when necessary for visits, procedures, surgery, treatment, and testing with the patient’s corresponding insurance company as authorized by the physician. The Authorization Specialist will serve as a liaison between the clinical team, provider, outside facilities and the patient.

SCHEDULE: Monday - Friday 8:00am - 4:30pm

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Screens and analyzes the patient’s medical records for the documentation and criteria required to meet medical necessity for the authorization process.
Obtains patients benefit information from the insurance company.
Familiarizes self with medical policies and criteria for each insurance company.
Follows up in a timely manner with the doctor’s team if additional information is needed.
Reviews clinical documents with Nurse Reviewers and/or Utilization Managers at various insurance companies and third-party administrators.
Coordinates with other OSS department staff, external facility staff and external companies to ensure authorization/referral is obtained.
Communicates with external locations to ensure shipment of injection to OSS.
Ensures authorization is secured with the insurance company prior to scheduled service.
Obtains authorization timely when the service requires an auth prior to scheduling.
Contributes to the development and delivery of team training initiatives.
Communicates with physician’s team to notify patients when unsuccessful at obtaining pre-certification/authorization.
Documents the results of the process in the EMR systems for future reference and for claims processing.
Addresses concerns of insurance companies as well as patients in a professional, calm and understanding fashion.
Maintains an orderly and neat work area.
Maintains confidentiality and always protects sensitive data, including and not limited to patient information.
Maintains performance in alignment with audit standards set by the team/department.
Creates and modifies vendor reports.
Other duties as assigned

EDUCATION:

High School Diploma or equivalent required; Licensed Practical Nurse (LPN) or certified Medical Assistant (MA) highly preferred.

EXPERIENCE/QUALIFICATIONS:

One-year relevant experience in the medical field or in prior authorization required.
Must have basic knowledge and understanding of CPT/ICD10 codes for insurance verification. Must have basic knowledge and understanding of medications, advanced imaging studies and surgical procedures.
Must have strong clinical knowledge and understanding of medical terminology and anatomy. Orthopedic knowledge is preferred.
Must have proficient computer skills, including Microsoft Office, and skills utilizing basic office equipment.
Must be detail oriented, have excellent organizational and prioritizing skills and be able to meet competing deadlines.
Must possess a high level of analytical skills and critical thinking.
Must be able to work independently. Must be able to demonstrate initiative to provide quality and improve efficiency with an assigned workload.
Must have excellent communication skills, both written and verbal, to ensure communication is accurate.
Must have good telephone etiquette, and be able to answer the phones, identify self and direct calls appropriately.
Must be able to demonstrate flexibility by adapting to new and changing duties to meet patient needs effectively and with efficiency.

BENEFITS INCLUDE:

Competitive Wages

Medical, Dental, Vision available on the first day of employment

Disability, and Life Insurance within 90 days

Company-Paid Group Life Insurance, Short-Term Disability & Long-Term Disability

Paid Time Off (PTO)

401(k) plan and profit sharing

Career Advancement Opportunities

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

prior authorization jobs in harrisburg, pa

Authorization Specialist

Medical Bill Review Supervisor

Case Manager (Pool/PRN)

Registered Nurse Clinical Case Manager - Heart and Vascular Services

Medical Office Associate - Harrisburg

Patient Access Representative

Medical Bill Review/Coding Specialist

Transplant Financial Coordinator - Bone Marrow Transplant

Patient Representative

PART-TIME MEDICAL ASSISTANT

Nutrition Care Coordinator

Central Insurance Referral Specialist II - Lemoyne

Front Desk Receptionist

Medical Assistant

Financial Counselor | Oncology

Clinical Care Assistant

Complex Rehab Lead - Harrisburg, PA

Medical Assistant

Customer Service Specialist- Sycamore Square Family Medicine (Full Time/Day & Evening Shift)

Field Reimbursement Manager

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