Medical Authorization Specialist

Socket.dev; Fair Lawn (NJ); On-site; USD 42,000 - 70,000; Full time

Job summary

VillageMD is seeking an Authorization Specialist to obtain prior authorizations for surgical procedures, diagnostics, DME, and referrals as part of the Revenue Cycle team. You will review schedules and system reports to identify items requiring authorization and verify insurance requirements across plans.

The role emphasizes compliance with carrier guidelines, timely processing, clear communication with patients and providers, and accurate entry in the patient account.

Qualifications

• HS diploma or GED required.
• 2–4 years related experience preferred.
• Epic and Microsoft Office proficiency preferred.

Responsibilities

• Identify appointments and procedures requiring authorization by monitoring schedules and reports.
• Verify insurance eligibility and benefits; update patient insurance information as needed.
• Complete referrals and prior authorizations timely according to workflows.

Skills

Communication

Customer service

Attention to detail

Teamwork

Education

High School Diploma or GED

Tools

Epic

Microsoft Office

Job description

VillageMD is seeking an Authorization Specialist to obtain prior authorizations for surgical procedures, diagnostics, DME, and referrals as part of the Revenue Cycle team. You will review schedules and system reports to identify items requiring authorization and verify insurance requirements across plans.

The role emphasizes compliance with carrier guidelines, timely processing, clear communication with patients and providers, and accurate entry in the patient account.