Top 127 Prior authorization specialist Jobs in New Jersey

Financial Services CoordinatorBusiness Specialist
ProCure Proton Therapy Center —Somerset, NJ
- Full-time
- Mid-level
- High school diploma or GED
- Clinic
- Health savings account
- Health insurance
Quick Apply
Prior Authorization Specialist
The Plastic Surgery Center —Red Bank, NJ
- $22 - $25 an hour
- Full-time
- Surgery
- HIPAA
- Mid-level
- Profit sharing
- Mileage reimbursement
Quick Apply
9d
Infusion Prior Authorization and Reimbursement Specialist
Kayal Orthopaedic Center, Joint Venture with RWJ Barnabas —Glen Rock, NJ
- $43 - $48 an hour
- Full-time
- High school diploma or GED
- Mentoring
- Organizational skills
- Health insurance
- Dental insurance
Quick Apply
22h
PAHub & Prior Authorization Specialist
Agadia Systems Inc —Parsippany-Troy Hills, NJ
- $60,000 - $200,000 a year
- Full-time
- Remote
- 5 years
- HIPAA
- Analysis skills
Quick Apply
7d
Authorization-Referrals Specialist III #Full Time
61st Street Service Corp —Fort Lee, NJ
- $28.72 - $36.92 an hour
- Full-time
- Mid-level
- 2 years
- Health insurance
- Paid time off
Quick Apply
AUTHORIZATION SPECIALIST
Cooper University Health Care —Camden, NJ
- Part-time
- Microsoft Excel
- Microsoft Outlook
- Medical office experience
- Health insurance
- Dental insurance
HEALTHCARE AUTHORIZATION / PRE-CERTIFICATION SPECIALIST
Advanced Obstetrics & Gynecology —Flemington, NJ
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
Prior Authorization/Scheduling Specialist - Orthopedics
Virtua Health —Moorestown, NJ
- $18.89 - $27.81 an hour
- Full-time
- Computer literacy
- Medical office experience
- High school diploma or GED
- AD&D insurance
- Disability insurance
Surgical Coordinator Authorization Specialist
Premier Orthopaedic Associates —Vineland, NJ
- $18 - $25 an hour
- Full-time
- Surgery
- Medical office experience
- High school diploma or GED
Quick Apply
Insurance Verification & Authorization Specialist
Rhythmedix —Mount Laurel, NJ
- $19 - $23 an hour
- Overtime
- Hybrid work
- HIPAA
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
Medicaid Authorization & Documentation Specialist
Volunteers of America - Greater New York, Inc. —Rahway, NJ
- $60,000 a year
- Full-time
- Mid-level
- Driver's License
- Bachelor's degree
- Paid holidays
- Health insurance
Quick Apply
Insurance Specialist
Regional Cancer Care Associates —Hackensack, NJ
- $18.99 - $29.22 an hour
- Part-time
- HIPAA
- Mid-level
- High school diploma or GED
9d
Credentialing & VOB/Authorizations Specialist ABA (Remote)
RightWay ABA —Clifton, NJ
- $21 - $28 an hour
- Full-time
- Remote
- Applied behavior analysis
- Mid-level
- 2 years
- Health insurance
- Dental insurance
Quick Apply
Patient Access Specialist
Hackensack Meridian Health —Hackensack, NJ
- From $27.13 an hour
- Full-time
- Spanish
- Hospital
- Computer literacy
- Health insurance
- Dental insurance
Accounts Receivable Insurance Authorization Specialist
Swan Hospice —Lakewood, NJ
- Full-time
- Mid-level
- Hospice & Palliative Medicine
Quick Apply
22h
Pharmacy Specialist I
Horizon Blue Cross Blue Shield of New Jersey —Hopewell, NJ
- $44,600 - $59,745 a year
- Full-time
- High school diploma or GED
- Organizational skills
- Computer skills
- Health insurance
- Dental insurance
2d
Medical Benefits Specialist
Asembia LLC —Livingston, NJ
- Full-time
- Microsoft Outlook
- 5 years
- Writing skills
Insurance Specialist I
Regional Cancer Care Associates —Hackensack, NJ
- $18.99 - $29.22 an hour
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- Wellness program
- Health savings account
9d
Prior Authorization Specialist
Advocare arthritis osteoporosis & rheumatology associates —Sewell, NJ
- $19 - $20 an hour
- Full-time
- Mid-level
- High school diploma or GED
- In-person
- Health savings account
- Paid holidays
Quick Apply
PT/Chiro Pre-Certification Specialist
Kayal Orthopaedic Center, Joint Venture with RWJ Barnabas —Glen Rock, NJ
- $23 - $24 an hour
- Full-time
- HIPAA
- In-person
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
6d

I want to receive the latest job alert for prior authorization specialist in new jersey

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

prior authorization specialist jobs near new jersey

Benefit Specialist jobs in Livingston, NJ

Insurance Verification Specialist jobs in Mount Laurel, NJ

Prior Authorization Specialist jobs in Moorestown, NJ

Authorization Specialist jobs in Camden, NJ

Patient Access Specialist jobs in Hackensack, NJ

Benefit Specialist jobs in Kissimmee, FL

Benefit Specialist jobs in Manassas, VA

Benefit Specialist jobs in Melbourne, FL

Entry Level Payroll Specialist jobs in Dallas, TX

Clinical Specialist jobs in California

Benefit Specialist jobs in Walt Disney World, FL

Community Support Specialist jobs in St. Louis, MO

Authorization Specialist jobs in New York, NY

Authorization Specialist jobs in Fort Lauderdale, FL

Authorization Specialist jobs in Fort Worth, TX

Insurance Authorization Medical jobs in Remote

Authorization Specialist jobs in Webster, TX

Remote Document Processing Specialist jobs in Atlanta, GA

Authorization Specialist jobs in Lincoln, NE

Peer Support Specialist jobs in Indiana

Financial Services CoordinatorBusiness Specialist

ProCure Proton Therapy Center -
Somerset, NJ

Quick Apply

Job Details

Full-time

Benefits

Health savings account
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
Life insurance
Paid sick time

Qualifications

Medical documentation
Phone communication
In-person customer service
Medical coding experience in outpatient clinics
Medical scheduling
High school diploma or GED
Organizational skills
Productivity software
Medical terminology
Client interaction via phone calls

Full Job Description

The Financial Business Specialist (FBS) is a part of the multidisciplinary team responsible for providing accurate and professional clearance, reviewing demographics, employment and insurance data necessary for payment of proton therapy treatment and verifies insurance coverage and benefits for our patients. Assists patients with financial counseling related coverage / reimbursement of proton healthcare related expenses. Assures that patients are financially cleared prior to patients being scheduled for consultations/simulations and that there are not any outstanding balances prior to clearance. May assist in collecting co-payments and payments prior to and during treatment. Communicates directly with physicians as required.

RESPONSIBILITIES :

Verify insurance benefits / financial information through a variety of means, ensuring that all insurance data, referrals, and authorizations provided are current, accurate, and not approaching expiration.
Determine the insurance policy coverage regarding proton beam radiation therapy, including, but not limited to, treatment site, diagnosis, clinical and testing prerequisites, limits of coverage, patient OOP responsibility, co-pay’s, referral, pre-authorization, and pre-determination requirements, etc.
Track and include the BID/QUAD cases on the authorizations to ensure continuous treatment coverage.
Document necessary approvals/denials from patient payer sources in both Mosaiq (MQ) and Vantage.
Review Vantage pipeline list daily for new patient’s pending verification of benefits and submission of authorization/pre-determination.
Educate patients on the insurance approval process for proton beam radiation therapy and any associated ancillary services needed from partner facilities (i.e., Anesthesia).
Provide explanations and/or guidance on insurance coverage and/or our available financial resources for patients.
Cross train to all areas of FBS responsibilities including finance appointments and collections of payment in the clinic area. Enter insurance information into MQ. Communicate directly with patients to relay their OOP/SPR responsibility.
Perform job activities using Electronic Medical Record (EMR), MQ and maintain the paperless patient insurance record.
Act as primary insurance interface between the Center and the partner physician practice(s).
Maintain current knowledge of Radiation Oncology insurance requirements.
Offer process improvement ideas regarding insurance and financial clearance to enhance patient satisfaction and improve current workflow.
Timely record accurate insurance/billing information in MQ.
Communicate clearly and effectively to team members and physicians regarding patients out of pocket expenses.
Close the loop with the Patient Service Specialist department regarding financial clearance and scheduling.
Review daily Capacity List regarding up-to-date financial clearance status.
Ensure direct communication with the Director, Commercial Payer Contracting. Ensure notification via email for all patients with NY/NJ Managed Medicaid plans to obtain “Single Case Agreement (SCA) or a Letter of Agreement (LOA) as required.
Track any change in patient treatment status. i.e. patients on break/hold, re-treat patients, treatment fraction changes and verify if the authorization on file covers said changes.
Review the buckets in Vantage to verify if any re-treat patient is listed under the “Payment to Patient” tab with an outstanding balance. Notify patient of outstanding balance that must be paid in full prior to start of new treatment.
Verify and update insurance benefits for all patients treated into the New Year, typically called the “rollover period”.
Communicate to the patient their OOP responsibility and payment expectations prior to consult / sim appointment.
Responsible for sending the financial clearance email to the physician, Finance Department, Patient Service Specialist department, and scheduling team.
Possess a thorough understanding of utilizing the QCL process for creating, following up, and completing the QCL’s with 100% compliance.
Respond to all physician emails received prior to the end of business daily.
Respond to phone call voicemails within 24 hrs.
Meet with patient on day of consultation/simulation to review financial information previously discussed. Obtain patient signature on the “Patient Responsibility Agreement” and necessary appeal forms, confirming with patient that the insurance we have on file is current and no changes/updates are needed. Collect any payment due on date of simulation.
Obtain authorization for any inhouse ordered PET CT, CT, and MRI exams.
Schedule Peer to Peer’s (P2P) with scheduling team for physicians for both PBRT and Radiology denials as needed.
Able to adapt and change workflow with updated processes and procedures.
Identify and contribute to Operational process improvement programs/initiatives to maximize efficiency and effectiveness of services provided.
Other duties as assigned by Manager.

WORK EXPERIENCE REQUIREMENTS :

A minimum of two years of experience in healthcare insurance.
Ideal candidate will possess experience with healthcare insurance processing and claims.
Experience performing electronic registration, financial hardship applications, insurance eligibility and enrollment
Experience interfacing with patients and their families regarding healthcare insurance coverage.

REQUIRED SKILLS AND ABILITIES :

Healthcare insurance / claims expertise
Exemplary customer satisfaction skills, including dealing effectively with customers, both in person and over the telephone
Proficient using Microsoft office products and electronic registration systems
Excellent written and verbal communication skills.
Understands ICD-9, ICD-10 and CPT coding
Medical terminology
Experience using Mosaiq / IMPAC software preferred
Experience using NaviNet and Passport for prior authorization and benefits preferred
Understands management of patient accounts via outsourced billing providers

COMPETENCIES :

Problem Solving/Analytical Skills

Organization, Attention to Detail & Time Usage

Performance Standards/Results Orientation

Competency/Dependability/Thoroughness

Interpersonal / Communication skills

EDUCATION/DEGREE :

HS Diploma or GED required

College Degree preferred

Job Type: Full-time

Benefits:

401(k)
Dental insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid sick time
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

prior authorization specialist jobs in new jersey

Financial Services CoordinatorBusiness Specialist

Prior Authorization Specialist

Infusion Prior Authorization and Reimbursement Specialist

PAHub & Prior Authorization Specialist

Authorization-Referrals Specialist III #Full Time

AUTHORIZATION SPECIALIST

HEALTHCARE AUTHORIZATION / PRE-CERTIFICATION SPECIALIST

Prior Authorization/Scheduling Specialist - Orthopedics

Surgical Coordinator Authorization Specialist

Insurance Verification & Authorization Specialist

Medicaid Authorization & Documentation Specialist

Insurance Specialist

Credentialing & VOB/Authorizations Specialist ABA (Remote)

Patient Access Specialist

Accounts Receivable Insurance Authorization Specialist

Pharmacy Specialist I

Medical Benefits Specialist

Insurance Specialist I

Prior Authorization Specialist

PT/Chiro Pre-Certification Specialist

I want to receive the latest job alert for prior authorization specialist in new jersey

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected