Orthopedics Pre-Authorization Specialist

Orthopedic Associates of; Englewood Cliffs (NJ); On-site; USD 42,000 - 52,000; Full time

Job summary

Orthopedic Associates of Englewood Cliffs is seeking a Full-Time Pre Authorization Representative. The role performs insurance precertification and authorization for orthopedic services, ensuring financial clearance before service date.

Requires medical office experience and CPT/ICD-10 knowledge. Responsibilities include verifying benefits, obtaining approvals, documenting actions in the EMR, and communicating with providers and insurers to maintain smooth pre-authorization processes.

Qualifications

• High school diploma or GED required.
• 1–2 years of experience preferred.
• Strong English communication, both oral and written.
• Knowledge of CPT and ICD-10 coding helpful.
• Knowledge of medical office terminology.
• Experience with standard office equipment and Windows-based systems.

Responsibilities

• Verify patient insurance benefits for in-office procedures.
• Obtain authorizations and notify insurers for services.
• Collect and verify demographic/billing information.
• Coordinate with providers to obtain necessary documentation for authorization.
• Document all pre-authorization actions in the EMR system.
• Research and appeal denied authorizations as needed.
• Provide timely updates to patients and healthcare providers.

Skills

Communication skills

Attention to detail

Organizational skills

EMR/EHR familiarity

Education

High school diploma or GED

1–2 years experience

Tools

EMR system experience

Job description

Orthopedic Associates of Englewood Cliffs is seeking a Full-Time Pre Authorization Representative. The role performs insurance precertification and authorization for orthopedic services, ensuring financial clearance before service date.

Requires medical office experience and CPT/ICD-10 knowledge. Responsibilities include verifying benefits, obtaining approvals, documenting actions in the EMR, and communicating with providers and insurers to maintain smooth pre-authorization processes.