Certified Medical Assistant Prior Authorization Specialist
4 weeks ago
Job Summary
We 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 Responsibilities
- Initiate and manage the prior authorization process for all obstetrical patients and gynecological patients.
- Communicate effectively with internal departments and insurance companies to obtain necessary authorization.
- Gather and organize patient medical records, treatment plans, and other relevant documentation required for authorization.
- Ensure all documentation provided meets insurance company requirements and guidelines.
- Collaborate with providers to obtain additional information or clarification as needed.
- 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.
- Monitor the progress of authorization requests and follow up as necessary to expedite approvals.
- 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.
Requirements
- National Certification from an accredited Medical Assistant Program.
- Current BLS.
- Womens 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.
- Detail-oriented and organized, with the ability to manage multiple tasks and prioritize workload effectively.
- Proficient computer skills, including experience with electronic medical records Epic systems and Microsoft Office Suite.
- Ability to work independently and as part of a team in a fast-paced environment.
- Familiarity with insurance company policies and procedures related to prior authorizations is a plus.
About Atlantic Health System
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. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania. 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.
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Morristown, New Jersey, United States Atlantic Health System Full timeJob 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...
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Morristown, New Jersey, United States Atlantic Health System Full timeWe 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...
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Medical Prior Authorization Specialist
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