Pre-Authorization Representative FT Evenings

Englewood Health; Englewood (NJ); On-site; USD 19,000 - 28,000; Full time

Job summary

Englewood Health is seeking a Pre-Authorization Representative to act as a liaison between physicians, patients, and insurance carriers to secure timely authorizations for tests, procedures and therapies. The role involves gathering patient data, ensuring payer compliance, and maintaining authorization records.

The position is full-time in Englewood, NJ, with evenings shifts, and requires strong data-entry skills, attention to detail, and knowledge of CPT/ICD/HCPCS coding.

Qualifications

• Excellent interpersonal and communications skills.
• Ability to function independently.
• Clerical, data entry and some typing skills, including: Filing and record keeping.
• Ability to work in fast paced environment.
• Flexible and able to pay close attention to details.
• Ability to complete needed tasks with speed and accuracy.
• Knowledge of CPT, ICD, HCPCS and/or drug codes.

Responsibilities

• Serve as a liaison between physicians, patients, and insurance carriers to secure authorizations and pre-certifications.
• Gather and verify patient demographic and clinical information.
• Ensure documentation meets payer requirements and maintain authorization records.
• Track certification status and support compliance with insurance guidelines.

Skills

Interpersonal skills

Independent work

Data entry

Typing skills

Fast-paced

Detail oriented

Medical codes CPT ICD HCPCS

Education

HS Diploma or GED

5+ years healthcare insurance experience

Job description

Pre-Authorization Representative FT Evenings

Englewood Health, is a leading healthcare system comprising Englewood Hospital and the Englewood Health Physician Network, is committed to delivering exceptional patient care across northern New Jersey. We are dedicated to fostering a supportive and inclusive work environment where every team member can bring their skills, creative ideas, positive approaches, and transforming the lives of patients and the communities we serve.

Job Summary:

Under general supervision, the Pre-Authorization Representative serves as a liaison between physicians, patients, and insurance carriers to secure timely authorizations and pre-certifications for medical tests, procedures, and therapies. This role contacts insurance companies on behalf of Medical Center physicians to obtain required approvals, gathers and verifies patient demographic and clinical information from physician offices, and ensures all documentation meets payer requirements. The representative performs accurate data entry, maintains authorization records, tracks certification status, and supports compliance with insurance guidelines to facilitate efficient patient care and reimbursement.

Department: Patient Access Services
Location: Englewood, NJ
Status: Full-time
Shift: 8 hour Evenings
Hours: Monday -Thursday 11:30a-7:30p; Sunday, 7:00a-3:00p

Job Essentials:

• Excellent interpersonal and communications skills
• Ability to function independently
• Clerical, data entry and some typing skills, including: Filing and record keeping
• Ability to work in fast fast-paced environment
• Flexible and able to pay close attention to details
• Ability to complete needed tasks with speed accuracy
• Knowledge of CPT, ICD, HCPCS and/or drug codes

Education Requirements:

• HS Diploma or GED education or minimum 5 years’ experience in related field (if HS or GED prepared, a minimum of one year of experience is required)
• One or more years of related insurance experience in a healthcare facility or physician's office preferred

Englewood Health job postings provide a minimum rate to comply with New Jersey Law. The rate of pay for each position will be determined based on a variety of factors including the candidate's relevant experience, qualifications, skills, etc. The minimum rate does not include bonuses/incentives, differential pay or other forms of compensation. In addition to the minimum rate, eligible employees may receive comprehensive benefits, including health insurance, retirement plans, paid time off, and other wellness resources. Minimum rate: $17.00

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