Insurance Authorization Liaison
2 weeks ago
St. Luke's values the expertise, dedication, and compassion of its workforce. Our employees are our greatest asset, committed to fulfilling our mission of excellence in caring for the sick and injured, educating healthcare professionals, and enhancing access to care in our communities, irrespective of patients' financial situations.
The Prior Authorization Coordinator plays a crucial role in managing insurance prior authorizations for patient prescriptions. This position serves as a bridge between healthcare providers, insurance entities, and patients to ensure effective insurance verification, secure prior authorizations, and resolve authorization challenges.
We are particularly interested in candidates residing in Pennsylvania and New Jersey, especially those near St. Luke's University Health Network facilities.
KEY RESPONSIBILITIES:
- Oversees prior authorization work queues and promptly verifies patient insurance details and eligibility necessary for obtaining medication prior authorizations.
- Employs various communication methods, including online platforms, fax, and phone, to acquire prior authorizations from insurance providers and accurately documents these in the medical records.
- Requests additional information and provides updates to patients and healthcare providers throughout the authorization process.
- Collaborates with insurance representatives to supply necessary clinical data to obtain prior authorization when required.
- Involves practice operations and the clinical care team when prior authorization attempts are unsuccessful or when alternative medications are needed.
- Escalates complex authorization issues to the Supervisor for further assistance and guidance.
- Maintains proficiency in St. Luke's electronic medical record system, internal tools, and online insurance platforms.
- Adopts a solution-oriented mindset to proactively address patient needs by collaborating with other team members and departments.
- Actively engages in performance improvement and quality enhancement initiatives.
- Performs other related duties as assigned.
PHYSICAL AND SENSORY REQUIREMENTS:
Ability to sit for extended periods, with consistent use of hands for typing and data entry. Occasional physical movements such as twisting and reaching may be required. Must be able to lift and carry items weighing up to 15 pounds. Requires good hearing for normal conversations and clear vision for reading and reviewing documents.
EDUCATION:
- High School diploma or equivalent.
TRAINING AND EXPERIENCE:
Required:
- Minimum of one year of experience in a healthcare setting or similar environment.
Preferred:
- Experience in customer service.
- Prior authorization experience.
- Background as a Medical Assistant.
We encourage applicants to submit their full legal name and current home address, along with a comprehensive employment history for the past seven years. Additionally, candidates are invited to upload a current resume detailing work history, education, and any relevant certifications or licenses. Creating a profile upon completing your application is highly recommended. Thank you for considering a career with St. Luke's.
St. Luke's University Health Network is an Equal Opportunity Employer.
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