Medical Prior Authorization Specialist

3 weeks ago

Morristown, New Jersey, United States Atlantic Health System Full time
Job Summary

We are seeking a skilled Medical Prior Authorization Specialist to play a critical role in our team. The ideal candidate will be responsible for obtaining prior authorization for all obstetrical patients, medication authorizations, and medical procedure authorizations from insurance companies.

Key Responsibilities
  • Coordinate with various departments to initiate and manage the prior authorization process for all obstetrical patients and gynecological patients.
  • Obtain necessary documentation, schedule peer-to-peer reviews, and meticulously document the entire authorization process.
  • Enter information on the PRA/SPECT Perinatal Risk Assessment & Single Point Entry Client Tracking for the State of New Jersey.
  • Gather and organize patient medical records, treatment plans, and other relevant documentation required for authorization.
  • Schedule and facilitate peer-to-peer reviews between providers and insurance company medical directors.
  • Document all communication and actions taken throughout the authorization process accurately and thoroughly.
  • Stay updated on changes in insurance policies, guidelines, and procedures related to prior authorizations.
  • Provide support and guidance to providers and staff regarding prior authorization requirements and processes.
  • Work in a CMA role with patients in various Women's Health departments as needed for additional coverage.
  • Provide any additional support for projects required within the departments.
Requirements
  • National Certification from an accredited Medical Assistant Program
  • Women's Health Experience Required
  • Prior experience working in a medical office or healthcare setting, preferably in a role involving prior authorizations.
  • Strong understanding of medical terminology, procedures, and pharmaceuticals.
  • Excellent communication skills, both verbal and written, with the ability to effectively interact with insurance companies, healthcare providers, and patients.
  • Proficient computer skills, including experience with electronic medical records Epic systems and Microsoft Office Suite.
  • Familiarity with insurance company policies and procedures related to prior authorizations is a plus.

Atlantic Health System is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time.

Our mission is to deliver exceptional care recognizing the unique needs of all those we serve.

Our vision is to achieve the best outcomes with our patients at the center of the physician-led team, driven by service, innovation and continuous learning.

Our integrated network offers seamless access to Atlantic Health System's entire health care continuum and our nationally and regionally ranked hospitals.

In collaboration with Atlantic Health System, several of our practices offer urgent care and walk-in services.

In addition to primary care physicians, the team includes specialists that care for patients in all aspects of their health from pediatrics to geriatrics and everything in between.

We make health decisions easier for patients with enhanced access to referrals.

Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.

  • Certified Medical Assistant Prior Authorization Specialist

    4 weeks ago

    Morristown, New Jersey, United States Atlantic Health System Full time

    We are seeking a skilled Medical Prior Authorization Specialist to support our team in delivering exceptional care to our patients.The ideal candidate will be responsible for obtaining prior authorization for all obstetrical patients, medication authorizations, and medical procedure authorizations from insurance companies.This role involves coordination with...

  • Certified Medical Assistant Prior Authorization Specialist

    3 weeks ago

    Morristown, New Jersey, United States Atlantic Health System Full time

    Job Summary:We are seeking a skilled Medical Prior Authorization Specialist to support our team in delivering exceptional care to our patients. The ideal candidate will be responsible for obtaining prior authorization for all obstetrical patients, medication authorizations, and medical procedure authorizations from insurance companies.Key...

  • Certified Medical Assistant Prior Authorization Specialist

    4 weeks ago

    Morristown, New Jersey, United States Atlantic Health System Full time

    Job SummaryWe are seeking a skilled Medical Prior Authorization Specialist to support our team at Atlantic Health System. The ideal candidate will be responsible for obtaining prior authorization for all obstetrical patients, medication authorizations, and medical procedure authorizations from insurance companies.Key ResponsibilitiesInitiate and manage the...

  • Medical Office Phone Associate

    3 weeks ago

    Morristown, New Jersey, United States Atlantic Health System Full time

    Job SummaryWe are seeking a skilled Phone Associate to join our team at Atlantic Health System. As a key member of our medical office staff, you will be responsible for managing phone calls, verifying insurance coverage, and maintaining schedules in our electronic medical record (EMR) system.Key ResponsibilitiesManage phone calls and respond to patient...

  • X-ray Imaging Specialist

    3 weeks ago

    Morristown, New Jersey, United States OneStaff Medical Full time

    X-ray Imaging SpecialistWe are OneStaff Medical, a nationally-recognized and independently-owned staffing firm dedicated to helping medical professionals find their dream assignments. As a X-ray Imaging Specialist, you will play a crucial role in visualizing the inside of the human body using cutting-edge imaging methods. Your expertise will help physicians...

  • Medical Specialist

    4 weeks ago

    Morristown, New Jersey, United States Enterprise Medical Recruiting Full time

    Enterprise Medical Recruiting OpportunityWe are assisting a private Neurology group in Morristown, NJ to recruit a new Neurologist. This is a 100% outpatient practice, offering a great work-life balance with no after-hours or weekend calls.Key Highlights:100% outpatient practiceFlexibility and great work-life balanceNo after-hours or weekend callsAbout the...

  • Veterinary Care Specialist

    3 weeks ago

    Morristown, New Jersey, United States Veritas Veterinary Partners Full time

    Opportunity for Veterinarians in Morristown, NJVeritas Veterinary Partners is seeking experienced Veterinarians to join our team at GSVS Veterinary Emergency Services Morristown in Morristown, New Jersey. This is an exciting opportunity for veterinarians who want to work in a fast-paced emergency setting and provide top-quality medical care to patients...

  • Traveling Registered Nurse

    4 weeks ago

    Morristown, New Jersey, United States Medical Solutions Full time

    Are you a skilled RN looking for a new adventure? Medical Solutions is hiring a Labor and Delivery Specialist for a rewarding opportunity in Morristown, NJ.As a travel nurse with Medical Solutions, you'll enjoy a competitive salary, comprehensive benefits, and the support of a dedicated recruiter. Our team is passionate about helping healthcare professionals...

  • Radiology Imaging Specialist

    3 weeks ago

    Morristown, New Jersey, United States FlexCare Imaging Full time

    FlexCare Imaging is seeking a skilled Radiology Imaging Specialist for a travel opportunity in New Jersey. The ideal candidate will have experience in diagnostic imaging and a strong understanding of radiology techniques.Job Details:Employment Type: TravelShift: 8 hours, daysDuration: 13 weeksBenefits:Competitive salary: $2,218/weekTax-free stipend amount to...

  • Administrative Support Specialist

    3 weeks ago

    Morristown, New Jersey, United States Mental Health Association Full time

    Job DescriptionAs an Administrative Assistant at Mental Health Association, you will play a vital role in supporting the day-to-day operations of our program. Your primary responsibilities will include:Providing exceptional customer service to clients and staff, responding to phone calls, and handling mail and correspondence.Managing office supplies,...

  • Medical Claims Specialist

    3 weeks ago

    Morristown, New Jersey, United States Travelers Insurance Full time

    Job SummaryWe are seeking a skilled Medical Claims Processor to join our team at Travelers Insurance. As a Medical Claims Processor, you will be responsible for handling Personal and Business Insurance Auto Bodily Injury claims from the first notice of loss through resolution/settlement and payment process.Key ResponsibilitiesProvides quality claim handling...

  • Relationship Specialist

    4 weeks ago

    Morristown, New Jersey, United States Affinity Federal Credit Union Full time

    Job DescriptionAffinity Federal Credit Union is seeking a Relationship Specialist to join our team. As a key member of our branch, you will be responsible for building member relationships by providing exceptional financial support and advice through a consultative and educational approach. This includes opening new accounts, enrolling new members,...

  • Medical Office Associate I

    3 weeks ago

    Morristown, New Jersey, United States Atlantic Health System Full time

    Job SummaryWe are seeking a highly skilled Medical Office Associate I to join our team in the Western Region. This per-diem position will provide coverage for various practices within the region.Key ResponsibilitiesManage phone calls and greet patients in a professional manner.Schedule and confirm appointments, ensuring seamless communication with patients...

  • Travel Mammography Imaging Specialist

    3 weeks ago

    Morristown, New Jersey, United States OneStaff Medical Full time

    We are OneStaff Medical, a nationally-recognized and independently-owned staffing firm dedicated to helping medical professionals find their dream assignments. Our team is forged in the Midwest, and we pride ourselves on standing by our candidates' sides every step of the way. If you're a like-minded individual who shares our passion for excellence, we want...

  • Insurance Risk Management Specialist

    4 weeks ago

    Morristown, New Jersey, United States US Tech Solutions Full time

    Job Title: Insurance Risk Management SpecialistJob Summary: We are seeking an experienced Insurance Risk Management Specialist to join our team at US Tech Solutions. The successful candidate will be responsible for managing various insurance programs, analyzing exposure data, and preparing presentations for renewal submissions.Key Responsibilities:Lead and...

  • Collision Repair Specialist

    4 weeks ago

    Morristown, New Jersey, United States Caliber Collision Centers Full time

    Job Summary:Caliber Collision has an immediate opening for an experienced Collision Repair Specialist to join our team. As a key member of our service center, you will be responsible for safely repairing vehicles in accordance with Caliber and OEM standards using our state-of-the-art equipment. Your expertise will be utilized to remove damaged fenders,...

  • Medical Social Worker

    3 weeks ago

    Morristown, New Jersey, United States Atlantic Health System Full time

    Patient-Centered CareAs a Medical Social Worker - Hospice Care Specialist at Atlantic Health System, you will play a vital role in providing comprehensive, integrated, and uninterrupted care to patients and their families. Your expertise will help enhance the patient's psychosocial situation, ensuring a seamless transition from hospital to community care.Key...

  • Travel Mammography Imaging Specialist

    4 weeks ago

    Morristown, New Jersey, United States OneStaff Medical Full time

    The Position:The Mammography Technologist, under direct supervision, performs specialized examinations of the breast to help in the diagnosis and treatment of breast disease in women patients for our client facilities.Mammography Technologist may perform screening exams or diagnostic exams.Benefits include: Insurance: Health, Dental, Vision, Life, Short Term...

  • Litigation Specialist, General Liability

    3 weeks ago

    Morristown, New Jersey, United States Travelers Insurance Full time

    Job SummaryWe are seeking a highly skilled Litigation Specialist to join our team at Travelers Insurance. As a key member of our claims team, you will be responsible for investigating, evaluating, and resolving General Liability related Bodily Injury and Property Damage claims.Key ResponsibilitiesDirectly handle assigned severe claims, providing quality...

  • Medical Office Coordinator

    4 weeks ago

    Morristown, New Jersey, United States Morris Dermatology Full time

    Job OverviewMorris Dermatology is seeking a highly organized and customer-focused Front Desk Associate to join our team.The ideal candidate will have prior experience in a medical office setting, excellent communication skills, and the ability to multitask in a fast-paced environment.Key Responsibilities:Provide exceptional customer service to patients and...