Top 27 Prior authorization specialist Jobs in Blairstown, Nj

Prior Authorization Specialist
Polaris Pharmacy Services —Rockaway, NJ
- $23 - $25 an hour
- Extended hours
- Microsoft Excel
- Microsoft Outlook
- Computer literacy
- Paid holidays
- Disability insurance
Quick Apply
Front Desk Specialist
Lehigh Valley Health Network —East Stroudsburg, PA
- Full-time
- Spanish
- Computer literacy
- BLS Certification
Surgical Scheduler for Joint Replacement Orthopedic Surgeon
Mountain Valley Orthopedics PC —East Stroudsburg, PA
- From $18 an hour
- Full-time
- Background check
- Surgery
- Pass drug screening
- Health insurance
- Dental insurance
Quick Apply
Surgical Scheduler for General Orthopedic Surgeon
Mountain Valley Orthopedics PC —East Stroudsburg, PA
- From $18 an hour
- Full-time
- Background check
- Surgery
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
Medical Office Associate I, Full Time - 8am-6pm, Family Medicine, Randolph
Atlantic Health System —Randolph, NJ
- Full-time
- Administrative experience
- High school diploma or GED
- Communication skills
- 403(b) matching
- AD&D insurance
14d
Medical Receptionist
Consensus Health LLC —Blairstown, NJ
- $15.49 - $23.00 an hour
- Full-time
- Computer literacy
- Basic math
- Administrative experience
- Paid holidays
- Disability insurance
Quick Apply
Surgical Scheduler
Premier Health Associates —Sparta, NJ
- From $21 an hour
- Email
- Surgery
- Medical office experience
- Mid-level
- Profit sharing
- Health insurance
Quick Apply
14d
Medical Receptionist - Float
Consensus Health LLC —Newton, NJ
- $18 - $22 an hour
- Full-time
- Computer literacy
- HIPAA
- Administrative experience
Quick Apply
Pharmacy Technician FrameworkLTC Data Entry & Billing Specialist
LTC Scripts Inc —Long Valley, NJ
- $40,000 - $55,000 a year
- Full-time
- Customer service
- HIPAA
- Mid-level
- Paid training
- Health insurance
Quick Apply

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Care Coordinator with Prior Authorization Specialty
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Employees are expected to maintain compliance with all practice policies and applicable federal and state regulations, including HIPAA, OSHA, patient…
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Insurance Verification and Prior Auth Specialist
Ohio Gastroenterology Group —Columbus, OH
Responds to patient calls about how out of network insurance is handled and provide patient with letter explaining this if necessary.
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Prior Authorization Specialist

Polaris Pharmacy Services -
Rockaway, NJ

Quick Apply

Job Details

Full-time
$23 - $25 an hour

Benefits

Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Paid time off
Vision insurance
Opportunities for advancement
Life insurance
Referral program

Qualifications

Computer operation
Microsoft Excel
Microsoft Outlook
Computer literacy
Basic math
Word embeddings
English
Research
High school diploma or GED
Customer engagement
Individual consumer customer service
Quality data entry

Full Job Description

WHO WE ARE
At Polaris Pharmacy Services, we’re more than a pharmacy — we’re a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we’re raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.

Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job — we provide competitive pay, robust benefits, and genuine opportunities for career advancement.

If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.

JOB SUMMARY:

The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior Authorization Specialist must be responsive and courteous when addressing our customers’ needs. Successful Specialists are dedicated to meeting the expectations and requirements of the position; understanding customer information and using it to improve products and services we deliver; talking and acting with customers in mind; establishing and maintaining effective relationships with co-workers and customers, thus gaining our customers’ trust and respect.

DUTIES/RESPONSIBILITIES:

Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers
Research, analyze and appropriately resolve rejected claims by working with national Medicare D plans, third party insurance companies, and all state Medicaid plans to ensure maximum payer reimbursement adhering to critical deadlines
Ensure approval of claims by performing appropriate edits and/or reversals to ensure maximum payer reimbursement
Contact providers and/or facility contacts as necessary to obtain additional information
Monitor and resolve revenue at risk associated with payer set up, billing, rebilling, and reversal processes
Work as a team to identify, document, communicate, and resolve payer/billing trends and issues
Complete, communicate, and submit prior authorizations forms in a timely manner
Support training needs
Prepare and maintain reports and records for processing
Perform other tasks as assigned.
Follow all applicable government regulations, including HIPAA
Comply with departmental policies regarding safety, attendance, and dress code
Overtime, holidays, and weekends may be required and/or expected
Conduct job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
Other duties as assigned; Job duties may vary depending on business needs

QUALIFICATIONS/COMPETENCIES:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

REQUIRED SKILLS/ABILITIES:

Able to read, write, speak, and understand the English language
Able to retain a large amount of information and apply that knowledge to related situations
Able to work in a fast-paced environment
Basic computer knowledge skills required
Basic math and analytical skills
Experience with alpha-numeric data entry
Proficient in Microsoft Word, Excel, and Outlook required
Customer Service
Results-oriented
Good organization/Attention to detail
Reliable
Problem solver
Able to work various shifts and days
Adaptability to an ever-changing environment

EDUCATION and/or EXPERIENCE:

High School diploma or equivalent required
Minimum of one (1) or more years working as a pharmacy technician in a retail environment preferred (long-term care pharmacy preferred)
Framework LTC & General computer knowledge & 10-key Number Entry preferred

PHYSICAL DEMANDS

The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:

May sit or stand seven (7) to ten (10) hours per day
The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walk
May be necessary to work extended hours as needed
May lift and/or move up to 30 pounds
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role

HOLIDAY & PTO POLICY

Paid holidays are provided annually, with 6 days offered each year, along with 5 sick days.
Employees earn up to 10 PTO days each year, with rollover options and milestone bonuses.
Employees have the option to cash out up to 10 PTO hours each quarter for added financial flexibility.

Please note, because we are a pharmacy most of our locations are open 24-hours a day, 7 days a week and therefore schedules may change as determined by the needs of the business.

BENEFITS for full time Employees

Medical, Dental, and Vision insurance
401 (k) (available for Part Time & Full Time EEs)
Company Paid Life insurance
Short-term and Long-term disability insurance
Tuition reimbursement
Personal Time Off (PTO)
Competitive pay with annual performance reviews and merit-based raises
Career growth potential
Annual on-site voluntary Flu Vaccines
Employee referral bonus program

Quick Apply

Refine Your Search

prior authorization specialist jobs in blairstown, nj

Prior Authorization Specialist

Front Desk Specialist

Surgical Scheduler for Joint Replacement Orthopedic Surgeon

Surgical Scheduler for General Orthopedic Surgeon

Medical Office Associate I, Full Time - 8am-6pm, Family Medicine, Randolph

Medical Receptionist

Surgical Scheduler

Medical Receptionist - Float

Pharmacy Technician FrameworkLTC Data Entry & Billing Specialist

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