Top 477 Authorization representative Jobs in Philadelphia, Pa

Authorization Representative
Thomas Jefferson University and Hospitals —Abington, PA
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- AD&D insurance
- Disability insurance
Patient Access Representative
Redeemer Health —Meadowbrook, PA
- Full-time
- Computer literacy
- High school diploma or GED
- Computer skills
- Health insurance
- Dental insurance
Patient Services Representative I
GSPP Rehabilitation —Philadelphia, PA
- Full-time
- Physical & Rehabilitation Medicine
- High school diploma or GED
- Clinic
Customer Service Representative I
Versant Health —Philadelphia, PA
- $16.50 - $17.75 an hour
- Full-time
- Remote
- HIPAA
- High school diploma or GED
- 1 year
- Health insurance
- Dental insurance
11d
Patient Care Coordinator
CCRM Fertility —Philadelphia, PA
- $25 - $30 an hour
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- Commuter assistance
- Health savings account
Quick Apply
Medical Scheduling Call Center Representative
Delaware Valley Management —Newtown, PA
- Full-time
- Remote
- HIPAA
- High school diploma or GED
- 1 year
Quick Apply
2d
Territory Sales Consultant, Bethlehem
IGS Energy —Philadelphia, PA
- $50,000 - $100,000 a year
- Full-time
- Background check
- Clean driving record
- Driver's License
- Paid training
- Wellness program
Quick Apply
SPECIALTY CARE TRANSPORT NURSE - UP TO $60/12p-12a
On Time Ambulance —Voorhees, NJ
- $52 - $60 an hour
- Overtime
- Acute care
- Patient monitoring
- RN License
- Health insurance
- Dental insurance
Quick Apply
Pharmacy Technician with Parata Experience
AidRx LLC —Huntingdon Valley, PA
- $20 - $24 an hour
- Full-time
- Bilingual
- HIPAA
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
Driver Manager/Dispatcher
Indian River Transport —Bensalem, PA
- $45,000 - $55,000 a year
- Full-time
- Computer literacy
- Mid-level
- Accounting
- Health insurance
- Dental insurance
Quick Apply
Accounts Receivable (AR) Specialist
Behavioral Milestones —Dresher, PA
- $55,000 - $62,000 a year
- Full-time
- Hybrid work
- Continuous improvement
- Children
- In-person
- Health insurance
- Dental insurance
Quick Apply
7d
Residential Therapist RTFA
PATH People Acting To Help, Inc. —Philadelphia, PA
- Part-time
- Mid-level
- Residential
- Driver's License
- Paid holidays
- Loan forgiveness
Quick Apply
Financial Services Sales Representative
Northwestern Mutual —Mount Laurel, NJ
- $120,000 - $165,000 a year
- Full-time
- Hybrid work
- Background check
- Sales
- Customer service
- Disability insurance
- Health insurance
Quick Apply
Packager-2nd shift
Polysciences, Inc. —Warrington, PA
- $19.20 an hour
- Overtime
- Forklift
- High school diploma or GED
- Team management
- Paid holidays
- Disability insurance
Quick Apply
7d
Flooring Sales + Flooring Design Consultant
Norman Carpet & Flooring —Bryn Mawr, PA
- $55,000 - $90,000 a year
- Weekends as needed
- Sales
- Customer service
- No background check
- Health insurance
- Paid time off
Quick Apply
Clinical Marketing Nurse Liaison
Weisman Children's Rehabilitation Hospital —Marlton, NJ
- $86,500 - $96,600 a year
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
Quick Apply
Clinical Marketing Nurse Liaison
Weisman Children's Rehabilitation Hospital —Marlton, NJ
- $51,900 - $57,960 a year
- Part-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
Quick Apply
Territory Sales Manager
Acara Solutions —Pennsauken, NJ
- Up to $110,000 a year
- Call employer
- Background check
- Public speaking
- 3 years
- Profit sharing
Quick Apply
14d
Financial Advisor | Entrepreneurial Opportunity | Career Changers Welcome
Northwestern Mutual —Philadelphia, PA
- $52,000 - $148,000 a year
- Full-time
- Background check
- Mid-level
- Bachelor's degree
- Paid training
- Health insurance
Quick Apply
Athletic Trainer - Non-Surgical Clinical Assistant
Rothman Orthopaedics —Marlton, NJ
- $23 - $30 an hour
- Full-time
- Anatomy knowledge
- Vital signs
- Surgery
- Health insurance
- Dental insurance
Quick Apply
10d

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Authorization Representative

Thomas Jefferson University and Hospitals -
Abington, PA

Apply Now

Job Details

Full-time

Benefits

AD&D insurance
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Tuition reimbursement
Vision insurance
Life insurance
Retirement plan
Prescription drug insurance

Qualifications

Electronic health records (EHR) management
Medical insurance coverage verification
HIPAA
High school diploma or GED
ICD-10
Pre-authorization review for utilization management
Clinical documentation standards
Documentation review
Documentation reviews

Full Job Description

Job Details

Coordinates insurance benefits verification and secures prior authorizations for surgical procedures, diagnostic testing, medications, referrals, and related services. Interprets payer-specific authorization requirements and ensures compliance with health plan protocols. Supports revenue cycle operations by performing functions that promote accurate claims submission and timely reimbursement from insurance carriers and patients.

Job Description

Summary
Coordinates insurance benefits verification and secures prior authorizations for surgical procedures, diagnostic testing, medications, referrals, and related services. Interprets payer-specific authorization requirements and ensures compliance with health plan protocols. Supports revenue cycle operations by performing functions that promote accurate claims submission and timely reimbursement from insurance carriers and patients.

Job Duties

Collaborates with physicians and provider office staff in secure the appropriate authorization, referral based on medical necessity and the patients’ treatment plan.
Performs medical necessity review to ensure procedures and diagnoses meet payer requirements.
Obtain authorizations in compliance with network policies and communicates any exception to ordering office, patient, and manager).
Interfaces with insurance companies, both directly and indirectly, to verify coverage, benefits and obtain precertification.
Reviews and verifies additional clinical information, insurance authorizations and referrals as needed.
Monitors work queues and patient schedules to ensure accurate authorization are in place prior to each visit.
Maintains compliance with benchmark metrics for accounts registered versus scheduled procedures.
Calculates estimated patient financial responsibility using insurance verification, payer contracts, and self-pay guidelines. and/or self-pay guidelines.

Minimum Qualifications

High School Diploma/GED
1 year experience in healthcare insurance verification, prior authorization requirements, and insurance benefits structures.
Experience working with multiple insurance payers and understanding medical necessity requirements.
Priorexperience working with electronic health record (EHR) systems and insurance portals.
Familiarity with clinical documentation and interpretation of treatment plans.
Knowledge of CPT, ICD-10 and HCPS coding as it relates to authorizations
Knowledge of patients right and laws relative to patients rights such as HIPPA

Preferred Qualifications

Associate’s Degree in health administration, healthcare management or related field preferred.

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University

Primary Location Address

1200 Old York Road, Abington, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University , home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health , nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps ), have access to medical (including prescription) insurance.

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Refine Your Search

authorization representative jobs in philadelphia, pa

Authorization Representative

Patient Access Representative

Patient Services Representative I

Customer Service Representative I

Patient Care Coordinator

Medical Scheduling Call Center Representative

Territory Sales Consultant, Bethlehem

SPECIALTY CARE TRANSPORT NURSE - UP TO $60/12p-12a

Pharmacy Technician with Parata Experience

Driver Manager/Dispatcher

Accounts Receivable (AR) Specialist

Residential Therapist RTFA

Financial Services Sales Representative

Packager-2nd shift

Flooring Sales + Flooring Design Consultant

Clinical Marketing Nurse Liaison

Clinical Marketing Nurse Liaison

Territory Sales Manager

Financial Advisor | Entrepreneurial Opportunity | Career Changers Welcome

Athletic Trainer - Non-Surgical Clinical Assistant

I want to receive the latest job alert for authorization representative in philadelphia, pa

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